Empyema

Respiratory (12%) Core Clinical Conditions

1B The Physician Associate is able to identify the condition as a possible diagnosis: may not have the knowledge/resources to confirm the diagnosis or to manage the condition safely, but can take measures to avoid immediate deterioration and refer appropriately

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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management

Empyema is a medical condition where there is a build up of pus in the pleural space of the lungs. 

• Pneumonia.

• Lung abscess.

• A recent thoracic surgery.

• Trauma.

• Weak immune system.

• Alcoholism.

• Chronic obstructive pulmonary disease (COPD)

• Foreign body aspiration.

• Lung cancer.

• Pleural effusion.

1. The pleural space typically has a small amount of fluid. The lungs use this as lubricant as they expand and contract.

2. If pleural space becomes infected > pus builds up > difficult for body to drain > prolonged infection > prolonged disease + increased risk of sepsis.

• Lung infections such as pneumonia, tuberculosis, and other lung infections.

• Chronic lung disease such as Chronic obstructive pulmonary disease (COPD), asthma, and others.

• Smoking

• Compromised immune system.

• Recent chest trauma or surgery.

• Foreign body/ objects in the lungs.

• Alcoholism.

• Older age. 

• Malnutrition.

• Obesity.

• Pleuritic chest pain

• Cough sometimes with blood-tinged sputum. 

• Shortness of breath

• Fever

• O/E: dullness on percussion, reduced chest expansion.

• Chest X-ray. 

• CT scan.

• Blood tests

• Pleural fluid analysis.

• Biopsy.

• Antibiotics. 

• Thoracentesis: a needle used to remove fluid in pleural space. 

• Drainage: a chest tube to drain pus in pleural space.

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