What is empyema?

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Empyema is described as pockets of pus that accumulated within a body cavity. This can form if a bacterial infection is not properly treated or fails to respond to treatment. Remember that this is a serious condition that necessitates treatment.

It can trigger fever, breathlessness, chest pain and coughing up mucus. Even though it might be life-threatening occasionally, it is not a common condition since most bacterial infections are fully treated with antibiotics before they progress to this phase.

What are the causes?

The lungs and the interior of the chest cavity are coated with a smooth lining known as the pleura. These are almost in contact with one another but separated by a thin space (pleural space) that is filled with a small amount of pleural fluid.

empyema
It can trigger fever, breathlessness, chest pain and coughing up mucus.

This pleural fluid can oftentimes accumulate and become infected which leads to the buildup of pus. This can thicken and cause areas of the pleura to adhere together, resulting to pockets of pus.

It is important to note that empyema can become worse with several more pus pockets with dense deposits that coat the exterior film of the lungs. These are known to disrupt the lungs from fully expanding.

The usual cause of empyema is pneumonia which is due to a bacterial infection of the lungs. Other possible causes include:

  • Blood clot or other form of obstruction that prevents blood flow to the lungs
  • Bronchiectasis
  • Chest surgery
  • Significant injury or damage to the chest
  • Endoscopy
  • Tuberculosis
  • Infection in a different part of the body that spreads via the bloodstream
  • Infection that arises after inhaling food especially those with swallowing issues

What are the indications?

It is important to note that empyema can be quite distressing and unpleasant. In most cases, it triggers the following:

  • Fever
  • Lack of energy
  • Night sweating
  • Chest pain
  • Difficulty breathing
  • Cough with mucus containing pus
  • Weight loss

Management of empyema

Antibiotics

In some cases, antibiotics are required which are administered intravenously. Nevertheless, the individual should be hospitalized for a long span of time.

Chest drainage

Some individuals might require both antibiotics and the placement of a chest drain. A chest drain is a flexible plastic tube that is inserted via the chest wall and into the affected area to drain out the fluid. The site where the tube is introduced is numbed and the individual is provided with a light sedative before the drain is inserted.

Pain medications are provided to lessen the discomfort while the chest drain is in position. The tube is kept in place until an ultrasound or X-ray reveals that the fluid has been drained from the chest while the lungs are completely expanded. Oftentimes, injections might be given via the chest drain to clear up the infected pus pockets.

Surgical removal of the lung lining

Surgery might be necessary if the condition does not seem to improve. The procedure involves the creation of an incision in the chest to allow access to the lungs and getting rid of the dense layer that coats the lungs to allow full expansion. Remember that this option is usually the last approach if other treatment options failed to work.

Stoma

If a chest drain is not suitable for the individual, a stoma is opted which is an opening created in the chest. A special bag is placed over the stoma to collect fluid leaking from the empyema. This is usually worn on the body and more discreet and disrupts less with the lifestyle of the individual.

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