Empyema
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Introduction
Empyema is infection of the pleural space.
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.
Causes and Risk Factors
Empyema usually follows pneumonia 2-3 weeks later.
Organisms include:
Pathophysiology
Three stages
- exudative
- fibrinopurulent
- organized
Signs and Symptoms
- history
- physical exam
History
- Dyspnea
- cough
- chest pain
- general malaise
Physical Exam
- fever
- decreased air entry
- decreased respiratory excursion
- intercostal narrowing
- percussion dullness
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Diagnostic Imaging
Chest X ray
- air-fluid levels
Differential Diagnosis
Treatments
A chest tube or small-bore catheter will work during the exudative stage.
If loculated, a chest tube should be used along with intrapleural fibrinolytic. Thorasocopy is an alternative. Thoracotomy with decortication, is a last resort.
Antibiotics are less important.
Consequences and Course
Resources and References
Topic Development
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