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{{Infobox_Disease
| Name          = {{PAGENAME}}
| Image          = Hydro pneumothorax.jpg
| Caption        = CT chest showing large right sided hydro-pneumothorax from pleural [[empyema]]. ''Arrows A: air, B: fluid''
| DiseasesDB    = 4200
| ICD10          = {{ICD10|J|86||j|85}}
| ICD9          = {{ICD9|510}}
| MedlinePlus    = 000123
| MeshID        = D016724
}}
{{Pleural_empyema}}
{{Pleural_empyema}}
'''For the WikiPatient page for this topic, click [[Pleural empyema (patient information)|here]]'''


{{CMG}}
'''For patient information, click [[Pleural empyema (patient information)|here]]'''


{{EH}}
{{CMG}} {{AE}} {{PTD}}


A '''pleural [[empyema]]''' (also known as a '''pyothorax''' or '''purulent pleuritis''') is an accumulation of [[pus]] in the [[pleural cavity]]. Most pleural empyemas arise from an infection within the [[lung]] ([[pneumonia]]), often associated with [[parapneumonic effusions]]. There are three stages: [[exudative]], fibrinopurulent and organizing. In the exudative stage, the pus accumulates. This is followed by the fibrinopurulent stage in which there is loculation of the pleural fluid (the creation of grapelike pus pockets). In the final organizing stage, scarring of the pleural space may lead to lung entrapment.
{{SK}} Empyema thoracis, Thoracic empyema, Pyothorax; Empyema - plural; Pleurisy - purulent
==[[Pleural empyema overview|Overview]]==


==Symptoms==
==[[Pleural empyema historical perspective|Historical Perspective]]==


Symptoms of empyema may vary in severity. Typical symptoms include: [[fever]], [[chest pain]] or discomfort, [[cough]], sweating and [[dyspnea|shortness of breath]].
==[[Pleural empyema classification|Classification]]==


[[Clubbing]] of the fingernails may be present. There is a dull percussion note and reduced breath sounds on the affected side of the chest.  Other diagnostic tools include chest [[x-ray]], [[CT scan]], and [[Medical ultrasonography|ultrasonography]].
==[[Pleural empyema pathophysiology|Pathophysiology]]==
 
==[[Pleural empyema causes|Causes]]==
 
==[[Pleural empyema differential diagnosis|Differentiating Pleural empyema from other Diseases]]==
 
==[[Pleural empyema epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Pleural empyema screening|Screening]]==
 
==[[Pleural empyema risk factors|Risk Factors]]==
 
==[[Pleural empyema natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Diagnosis==
==Diagnosis==
Diagnosis is confirmed by [[thoracentesis]]; frank pus may be aspirated from the pleural space. The pleural fluid typically has a low pH (<7.20), low glucose (<60 mg/dL), and contains infectious organisms.
[[Pleural empyema history and symptoms|History and Symptoms]] | [[Pleural empyema physical examination|Physical Examination]] | [[Pleural empyema laboratory findings|Laboratory Findings]] | [[Pleural empyema chest x ray|Chest X Ray]] | [[Pleural empyema ECG|ECG]] | [[Pleural empyema CT|CT]] | [[Pleural empyema MRI|MRI]] | [[Pleural empyema ultrasound|Ultrasound]] | [[Pleural empyema other imaging findings|Other Imaging Findings]] | [[Pleural empyema other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
Definitive treatment for empyema entails drainage of the infected pleural fluid.  A [[chest tube]] may be inserted, often using ultrasound guidance. [[Intravenous]] [[antibiotic]]s are given. If this is insufficient, surgical [[debridement]] of the pleural space may be required.
[[Pleural empyema medical therapy|Medical Therapy]] | [[Pleural empyema surgery|Surgery]] | [[Pleural empyema prevention|Prevention]] | [[Pleural empyema cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] [[Pleural empyema future or investigational therapies|Future or Investigational Therapies]]
 
==Case Studies==
 
[[Pleural empyema case study one|Case #1]]


{{Respiratory pathology}}
{{Respiratory pathology}}

Latest revision as of 04:52, 9 March 2017

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]

Synonyms and keywords: Empyema thoracis, Thoracic empyema, Pyothorax; Empyema - plural; Pleurisy - purulent

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pleural empyema from other Diseases

Epidemiology and Demographics

Screening

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | ECG | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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