Empyema

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Empyema

A pleural empyema
Empyema

A pleural empyema is an accumulation of pus in the pleural cavity. Most pleural empyemas arise from an infection within the lung , often associated with parapneumonic effusions....
(also known as a pyothorax or purulent pleuritis) is an accumulation of pus

Pus

Pus is a whitish-yellow, yellow or yellow-brown substance produced during inflammatory pyogenic bacteriuml infection. An accumulation of pus in an enclosed tissue space is known as an abscess....
in the pleural cavity

Pleural cavity

In human anatomy, the pleural cavity is the body cavity that surrounds the lungs. The lungs are surrounded by the pleurae, a serous membrane which folds back upon itself to form a two-layered, membrane structure....
. Most pleural empyemas arise from an infection within the lung

Lung

The lung is the essential respiration organ in air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located in the chest on either side of the heart....
(pneumonia

Pneumonia

Pneumonia is an Inflammation illness of the lung. Frequently, it is described as lung parenchyma/alveolus inflammation and abnormal alveolar filling with fluid ....
), 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).

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Encyclopedia

Pus

Pleural cavity

Lung

Pneumonia

Symptoms

Symptoms of pleural empyema may vary in severity. Typical symptoms include: fever

Fever

Fever is a frequent medical sign that describes an increase in internal body temperature to levels above normal. Fever is most accurately characterized as a temporary elevation in the body's thermoregulatory set-point, usually by about 1?2 ?C ....
, chest pain

Chest pain

In medicine, chest pain is a symptom of a number of serious conditions and is generally considered a medical emergency. Even though it may be determined that the chest pain is non-cardiac in origin this is often a diagnosis of exclusion made after ruling out more serious causes of pain....
or discomfort, cough

Cough

A cough , in medicine, is a sudden and often repetitively occurring defense reflex which helps to clear the large breathing passages from excess secretions, irritants, foreign particles and microbes....
, sweating and shortness of breath

Dyspnea

Dyspnea or dyspnoea , from Latin language dyspnoea, from Greek language dyspnoia from dyspnoos, shortness of breath) or shortness of breath is perceived to be difficulty of breathing or painful breathing that a patient is aware of....
.

Clubbing

Clubbing

In medicine, clubbing, finger clubbing, or digital clubbing is a deformity of the fingers and Nail s that is associated with a number of diseases, mostly of the heart disease and lung disease....
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

X-ray

X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 10 to 0.01 nanometers, corresponding to frequency in the range 30 Hertz to 30 Hertz and energies in the range 120 Electron volt to 120 keV....
, CT scan, and ultrasonography

Medical ultrasonography

Diagnostic sonography is an ultrasound-based diagnostic medical imaging technique used to visualize subcutaneous body structures including tendons, muscles, joints, vessels and internal organs for possible pathology or lesions....
.

Diagnosis

Diagnosis is confirmed by thoracentesis

Thoracentesis

Thoracentesis is an invasive procedure to remove pleural effusion or pneumothorax from the pleural cavity for diagnostic or therapeutic purposes....
; 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.

Treatment

Definitive treatment for pleural empyema entails drainage of the infected pleural fluid. A chest tube

Chest tube

A chest tube is a flexible plastic tube that is inserted through the side of the chest into the pleural cavity. It is used to remove air or fluid , or pus from the intrathoracic space....
may be inserted, often using ultrasound guidance. Intravenous antibiotic

Antibiotic

In common usage, an antibiotic is a substance or compound that kills or inhibits the growth of bacteria. Antibiotics belong to the group of antimicrobial compounds used to treat infections caused by microorganisms, including fungus and protozoa....
s are given. If this is insufficient, surgical debridement

Debridement

Debridement is the medical removal of a patient's dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue....
of the pleural space may be required.

External links

from MedPix