Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]
Overview
Before the development of antibiotics, Streptococcus pneumoniae was the most common bug found in empyemas. More recently, however, anaerobes have become the predominant organism in culture positive empyemas (and therefore careful anaerobic cultures should always be sent when working up parapneumonic effusions). Mixed aerobic and anaerobic infections are also common, and virtually any bug can cause an empyema, however different bugs are associated with different rates of empyema formation.
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Causes by Organ System
Cardiovascular
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Purulent pericarditis
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Chemical/Poisoning
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Chemical pleurodesis, talc pleurodesis
|
Dental
|
No underlying causes
|
Dermatologic
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Ulcer
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Drug Side Effect
|
No underlying causes
|
Ear Nose Throat
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Acute mastoiditis, sinusitis
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Endocrine
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Diabetes
|
Environmental
|
No underlying causes
|
Gastroenterologic
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Cholecystitis, esophageal rupture, gallbladder empyema, liver abscess
|
Genetic
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Chronic granulomatous disease
|
Hematologic
|
No underlying causes
|
Iatrogenic
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Lung transplantation, pneumonectomy
|
Infectious Disease
|
Actinomyces, acute mastoiditis, anaerobic infection, bacterial meningitis, bacteroides, brain abscess, bronchiectasis, candida, capnocytophaga, community-acquired pneumonia, echinococcus, entamoeba histolytica, fusobacterium, haemophilus influenzae, HIV, infection, klebsiella pneumoniae, Lemierre's syndrome, liver abscess, lung abscess, mycobacterium tuberculosis, mycoplasma hominis, mycoplasma, nocardia, nocardiosis, odontogenic infection, orbital cellulitis, pasteurella multocida, pneumonia, purulent pericarditis, rhodococcus equi, sinusitis, staphylococcus aureus, streptococcus anginosus, streptococcus pneumoniae infection, streptococcus pyogenes, streptococcus, subdural empyema, tularemia, typhoid fever, yersinia
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Musculoskeletal/Orthopedic
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Ulcer
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Neurologic
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Bacterial meningitis, brain abscess
|
Nutritional/Metabolic
|
No underlying causes
|
Obstetric/Gynecologic
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No underlying causes
|
Oncologic
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Bronchogenic carcinoma, tumor
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Ophthalmologic
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Orbital cellulitis
|
Overdose/Toxicity
|
No underlying causes
|
Psychiatric
|
No underlying causes
|
Pulmonary
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Bronchiectasis, bronchogenic carcinoma, chemical pleurodesis, community-acquired pneumonia, lung abscess, lung transplantation, mycobacterium tuberculosis, pleural effusion, pneumonectomy, pneumonia, talc pleurodesis
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Renal/Electrolyte
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Nephrotic syndrome
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Rheumatology/Immunology/Allergy
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Chronic granulomatous disease, immunocompromised
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Sexual
|
No underlying causes
|
Trauma
|
No underlying causes
|
Urologic
|
No underlying causes
|
Miscellaneous
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Fistula, foreign body, ulcer
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Causes in Alphabetical Order
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2
References