empyém

Empyema is a medical condition characterized by the accumulation of pus within the pleural cavity, the space between the layers of tissue that line the lungs and chest wall. It is typically a complication of pneumonia, though it can also arise from other infections, trauma, or surgical procedures. The condition is classified into three stages based on the progression and characteristics of the fluid: exudative (early), fibrinopurulent (middle), and organized (late).

Symptoms of empyema often include persistent chest pain, fever, chills, cough, and shortness of breath. Physical examination may reveal reduced breath sounds on the affected side, along with signs of consolidation or pleural friction rub. Diagnosis is confirmed through imaging studies such as chest X-rays, computed tomography (CT) scans, or ultrasound, which show fluid collection in the pleural space. Further evaluation with thoracentesis—removal of fluid for analysis—helps identify the presence of pus and underlying causes.

Treatment primarily involves drainage of the pus, often through thoracentesis or placement of a chest tube, combined with antibiotic therapy tailored to the identified pathogens. In severe or complicated cases, surgical intervention such as decortication (removal of thickened pleural tissue) may be necessary. Prompt treatment is critical to prevent complications, including lung collapse, chronic pleural disease, or systemic infection.

Empyema is more common in individuals with weakened immune systems, those hospitalized for prolonged periods, or those with underlying lung diseases. Prevention strategies focus on early and effective treatment of pneumonia and other infections, as well as improving overall respiratory health. With appropriate care, most patients recover fully, though some may experience long-term effects depending on the severity and duration of the condition.