Empyema
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The term empyema is most commonly used to refer to pus-filled pockets that develop in the pleural space. This is the slim space between the outside of the lungs and the inside of the chest cavity. They can form if a bacterial infection is left untreated, or if it fails to fully respond to treatment.
Empyema is a serious condition that requires treatment. It can cause fever, chest pains, breathlessness and coughing up mucus. Although it can occasionally be life threatening, it’s not a common condition, as most bacterial infections are effectively treated with antibiotics before they get to this stage.
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Private treatment in our hospital network allows you skip waiting lists while at the same time reducing the costs treatment considerably, up to 50% cheaper, in countries that are just a short flight from home. The countries listed below make excellent choices with modern hospitals and well-trained English speaking surgeons.
Our medical consultants will advise you on the best choice for empyema in one of our leading hospitals. We will evaluate your current condition, expectations and other related factors, and offer you the most suitable option, respecting your health and the individual needs of your body and lifestyle. Your health is unique and so should be your solution.
- Berlin
- Zurich
- Vienna
- Paris
- Madrid
- Milan
- Warsaw
- Istanbul
Treatment of Empyema
Some patients may need both antibiotics and a chest drain. A chest drain is a flexible plastic tube that’s inserted through the chest wall and into the affected area to drain it of fluid. The area where the tube is inserted is numbed, and the patient may also be given a light sedative before having the drain inserted. Painkillers are given to ease any pain while the chest drain is in.
The chest tube usually stays in place until an X-ray or ultrasound scan shows all the fluid has drained from the chest and the lungs are fully expanded. Sometimes injections may be given through the chest drain to help clear the infected pockets of pus.
The patient may need to stay in hospital until the tube is removed. Some patients may be able to go home with the chest tube still in place, in which case a specialist nurse will offer support and advice on how to manage this at home. The nurse will demonstrate how to position, empty and change the bag until the family or patient feels confident they can do this themselves.
Surgery may be needed if the condition doesn’t improve. Decortication involves removing the pus pockets and fibrous tissue from the pleural space, which helps the lungs expand. For draining the fluid, there are two options. In most cases, a surgeon performs a video-assisted thoracotomy (VATS), which is less invasive than the alternative. VATS also involves less pain and a shorter recovery period. The other option is an open thoracotomy, which requires a surgeon to open the chest.
Complications of Empyema
Complications
Causes
Symptoms
Diagnosis
Complications
Possible complications of empyema include:
- Fibrosis: Damaged lung tissue can cause difficulty breathing that affects a person’s quality of life. If this difficulty continues for 6 months after the infection, decortication surgery may help.
- Empyema necessitatis: This involves the infection extending into the chest wall and soft tissue. It is rare but requires immediate medical attention.
Causes
The most common cause of empyema is pneumonia caused by a bacterial infection of the lungs.
An empyema can form when pneumonia fails to fully respond to treatment in a straightforward way.
Other possible causes are:
- bronchiectasis – a long-term condition where the airways of the lungs become abnormally widened, leading to a build-up of mucus that can make the lungs more vulnerable to infection
- a blood clot or another blockage – this can prevent blood flow to the lungs, causing some of the lung tissue to die (known as a pulmonary infarction)
- surgery to the chest – empyema is a rare complication
- an endoscopy – empyema is a rare complication
- serious injury to the chest
- an infection elsewhere in the body that’s spread through the bloodstream
Symptoms
An empyema can be distressing and uncomfortable.
It can cause:
- a fever and night sweats
- a lack of energy
- difficulty breathing
- weight loss
- chest pain
- a cough and coughing up mucus containing pus
Diagnosis
An empyema is usually suspected when a person with severe pneumonia doesn’t improve with treatment and they start to show some of the symptoms of empyema.
If the patient is coughing up mucus, a sample of this should be taken to be inspected under a microscope. The type of bacteria causing the infection is identified so the most effective antibiotics can be given. A blood sample will also be taken to count the number of white blood cells and other markers of infection.
An X-ray or ultrasound scan will show whether there’s a collection of fluid building up around the lungs and how much there is. If there is fluid a sample will be taken and sent for analysis. Often a CT scan may also be used to give a more detailed assessment.
