Empyema

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD medical weight loss NYC and sleep center NYC

Empyema
Synonyms	Pyothorax, purulent pleuritis
Pronounce	N/A
Specialty	N/A
Symptoms	Chest pain, fever, cough, shortness of breath
Complications	Sepsis, lung abscess, fibrothorax
Onset	Usually after pneumonia or lung infection
Duration	Can be acute or chronic
Types	N/A
Causes	Bacterial infection, pneumonia, lung abscess
Risks	Chronic obstructive pulmonary disease, diabetes, alcoholism, immunosuppression
Diagnosis	Chest X-ray, CT scan, thoracentesis
Differential diagnosis	Pleural effusion, lung abscess, pneumothorax
Prevention	N/A
Treatment	Antibiotics, chest tube drainage, surgery
Medication	Antibiotics such as penicillin, cephalosporins, metronidazole
Prognosis	Variable, depends on underlying cause and treatment
Frequency	More common in children and elderly
Deaths	N/A

Empyema progression

Empyema denotes the collection of pus within an already existing anatomical cavity in the body. Distinct from an abscess, which refers to pus accumulation in a newly formed space, the term empyema has its etymological roots in the Greek language.

Pleural empyema

Etymology

The word empyema is derived from the Ancient Greek term "ἐμπύημα", which translates to "abscess". This historical linkage provides insights into how medical terminology has evolved and been shaped by early civilizations.

Overview and Key Distinctions

While both empyema and abscess involve the accumulation of pus, they are differentiated based on the location of this collection:

• Empyema: Accumulation of pus in a pre-existing anatomical cavity.
• Abscess: A collection of pus in a newly formed space due to infection or tissue breakdown.

Pleural Empyema

A common and clinically significant type of empyema is the pleural empyema. This condition pertains to the collection of pus in the pleural cavity, the space between the layers of the pleura that surround the lungs.

Causes

Pleural empyema typically arises due to:

• Bacterial infections in the lungs, such as pneumonia or tuberculosis.
• Complications following thoracic surgery.
• Trauma to the chest.

Symptoms

Patients with pleural empyema may experience:

• Chest pain
• Fever and chills
• Shortness of breath
• Persistent cough

Diagnosis and Treatment

Pleural empyema is usually diagnosed through imaging studies, such as X-rays or CT scans, and may be confirmed with the analysis of pleural fluid obtained through thoracentesis. Treatment involves draining the pus, often accompanied by antibiotics to address the underlying infection.

Conclusion

Empyema is a critical medical condition that requires timely intervention. Its differentiation from abscesses underlines the importance of understanding specific medical terminologies and their implications for diagnosis and treatment.

Differentiation from Abscess

It's crucial to differentiate an empyema from an abscess. While both denote a collection of pus, empyema refers to pus accumulation within a naturally occurring anatomical cavity. In contrast, an abscess represents pus within a new, pathologically created space.

Classification

Empyemas can manifest in various regions of the body. The categorization based on the anatomical site of occurrence includes:

• Pleural Cavity: Known as pleural empyema or pyothorax, it denotes pus collection within the space lining the lungs.
• Thoracic Cavity
• Uterus: Termed pyometra, it signifies pus within the uterine cavity.
• Appendix: Here, the condition is identified as appendicitis, showcasing pus in the appendix.
• Meninges: The condition is labeled subdural empyema when pus gathers between the meninges layers in the brain.
• Joints: Known as septic arthritis, it illustrates pus within joint spaces.
• Gallbladder

Clinical Implications

The accumulation of pus within any anatomical space can lead to complications and requires prompt medical attention. Diagnosis often involves imaging studies, and treatment could range from antibiotics to surgical intervention, depending on the severity and location of the empyema.

See Also

• Pneumonia
• Tuberculosis
• Pleura
• Abscess
• Pus
• Infection

References

• Clinical Management of Pleural Empyema. Thorax Journal.
• Empyema: Diagnosis and Treatment. American Thoracic Society.

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