Empyema
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| ICD-10 | J86. |
|---|---|
| ICD-9 | 510 |
An empyema is a collection of pus within a natural body cavity, most commonly the pleural space surrounding the lungs. It is usually caused by a bacterial infection of the lungs (pneumonia).
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[edit] Symptoms
Typical symptoms are just about the same as tuberculosis which includes: fever (which may be spiking), chest pain, cough, sweating and shortness of breath.
There is a dull percussion note and reduced breath sounds on the affected side of the chest. Chest x-ray shows a pleural effusion, often with a lateral bulge and pleural thickening. Ultrasound confirms the size and location of the pocket of pus and the presence of fibrin aggregates.
[edit] Diagnosis
Diagnosis is confirmed by thoracentesis. Frank pus may be aspirated from the pleural space. The pleural fluid has a low pH, high white cell count, high protein and low glucose content. Depending upon where the empyema is thought to be, for example in the case or an empyema in the area surrounding the brian, a lumbar puncture may be required as would extensive blood testing and culturing to determine the condition.
[edit] Treatment
A chest tube is inserted to drain the pus from the pleural space. Intravenous antibiotics are given. If this is insufficient, surgical decortication of the pleura may be required.
Some evidence suggests that intrapleural fibrinolytic drugs may be useful, especially in children.
[edit] External links
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