Materiały źródłowe

• #1 Thoracic Empyema – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544279/

  Thoracic empyema, characterized by the presence of purulent fluid in the pleural space, remains a significant clinical challenge with considerable morbidity and mortality. This condition typically arises as a complication of pneumonia, chest trauma, or surgery and is associated with the complex pathophysiologic processes of infection and inflammation. Early diagnosis and aggressive management, including antimicrobial therapy, drainage procedures, and sometimes surgery, are critical for favorable outcomes. […] Stemming from multifactorial etiologies, empyema progresses through distinct stages that clinicians must recognize for effective management. […] Prompt diagnosis and intervention are crucial for improving patient outcomes, as treatment hinges on integrating medical and surgical strategies to eradicate the infection and facilitate lung reexpansion.

• #2 Empyema: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000123.htm

  Empyema is a collection of pus in the space between the lung and the inner surface of the chest wall (pleural space). […] Symptoms of empyema may include any of the following: Chest pain, which worsens when you breathe in deeply (pleurisy), Dry cough, Excessive sweating, especially night sweats, Fever and chills, General discomfort, uneasiness, or ill feeling (malaise), Shortness of breath, Weight loss (unintentional). […] When empyema complicates pneumonia, the risk for permanent lung damage and death goes up. Long-term treatment with antibiotics and drainage are needed. […] In general, most people fully recover from empyema.

• #3 Empyema: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/24269-empyema

  Empyema symptoms are nonspecific and may include: Chest pain or discomfort. Fever. Trouble breathing. Cough. Extreme exhaustion (fatigue). Unexplained weight loss. […] Without proper treatment, empyema can get worse and may be fatal. If you have symptoms of empyema, call a healthcare provider right away. […] Empyema typically develops about four to six weeks after bacteria enter your lungs. […] Empyema isnt common. Most cases dont progress to later stages with early treatment. However, it can be fatal without proper treatment in 5% to 30% of people with empyema and other conditions (comorbidities). The mortality rate is about 40% in immunocompromised people who have empyema.

• #4 Empyema

  https://www.nhs.uk/conditions/empyema/

  Empyema is a serious condition that requires treatment. It can cause fever, chest pains, breathlessness and coughing up mucus. […] 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. […] 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.

• #5 Empyema: Causes, Types, and Symptoms

  https://www.healthline.com/health/empyema

  Empyema can be simple or complex. […] The symptoms of simple empyema include: shortness of breath, dry cough, fever, sweating, chest pain when breathing that may be described as stabbing, headache, confusion, loss of appetite. […] Complex empyema occurs in the later stage of the illness. […] Other symptoms in complex empyema include: difficulty breathing, decreased breath sounds, weight loss, chest pain. […] If the infection continues to get worse, it can lead to the formation of a thick peel over the pleura, called a pleural peel. […] The outlook for empyema with prompt treatment is good. […] However, in people with other conditions that compromise the immune system, empyema can have a mortality rate as high as 40 percent. […] If it’s not treated, empyema can lead to potentially life-threatening complications such as sepsis.

• #6 Empyema Treatment Specialists | NJ Infectious Disease Doctors | ID Care

  https://idcare.com/infection/empyema/

  Empyema is a collection of pus in the space between your lungs and the inner surface of your chest wall, also known as the pleural space. When pus enters the pleural space, it cannot be coughed out. Instead, it needs to be drained by a medical professional. Typically, an infection that spreads from the lung, such as pneumonia, causes empyema. While fluid naturally occurs in our lungs, empyema can cause infected fluid to accumulate — not only making it harder for your lungs to absorb liquid but also making it more difficult for you to breathe. […] The main symptoms of empyema include chest pain that worsens when you breathe in deeply, a dry cough, excessive sweating — especially at night — fever and chills, general discomfort, uneasiness or ill feelings, shortness of breath, and unintentional weight loss.

• #7 Empyema – UF Health

  https://ufhealth.org/conditions-and-treatments/empyema

  Symptoms of empyema may include any of the following: […] Chest pain, which worsens when you breathe in deeply (pleurisy) […] Dry cough […] Excessive sweating, especially night sweats […] Fever and chills […] General discomfort, uneasiness, or ill feeling (malaise) […] Shortness of breath […] Weight loss (unintentional) […] When empyema complicates pneumonia, the risk for permanent lung damage and death goes up. Long-term treatment with antibiotics and drainage are needed. […] In general, most people fully recover from empyema.

• #8 Empyema and Lung Infection – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/lung-center/diseases-and-conditions/empyema-and-lung-infection

  Empyema starts as thin infected tissue that prevents the lung from working. After a few days, this fluid becomes thick (gelatinous), and must be scraped out. If left inside, the gelatinous material turns to a scar on the lung like the peel of an orange. The last stage, pneumothorax, can cause permanent disability. […] Signs and symptoms of empyema and lung infections include: Chest pain, Dry cough, Excessive sweating, Fever and chills, Shortness of breath, Sharp or stabbing chest pain, Headache, Confusion, Loss of appetite, low energy, fatigue, Weight loss.

• #9 Pleural empyema | Thoracic Key

  https://thoracickey.com/pleural-empyema-2/

  The signs of empyema include fever, tachypnoea and tachycardia, in combination with the findings of a pleural effusion (decreased tactile fremitus, dullness to percussion and decreased breath sounds). […] Empyema necessitans refers to the extension of pleural infection outside the pleural cavity into the chest wall and overlying soft tissues.

• #10 Empyema: Symptoms, causes, and treatments

  https://www.medicalnewstoday.com/articles/323578

  Symptoms of empyema may include: having pneumonia that does not improve, a fever, chest pain, a cough, pus in mucus, difficulty breathing, a crackling sound in the chest, decreased breathing sounds, a dull sound when tapping chest. […] Without treatment, empyema can progress through three stages: Stage 1: Simple empyema. Another name for this stage is the exudative phase. It occurs when extra fluid begins to build up in the pleural cavity. This fluid can become infected and may contain pus. […] Stage 2: Complicated empyema. Another name for this stage is the fibrinopurulent phase. The fluid in the pleural cavity begins to thicken and form pockets. […] Stage 3: Frank empyema. Finally, the infected fluid causes scarring on the inner layers of the lungs. This causes difficulty breathing, as it keeps the lungs from inflating properly. Another name for this stage is the organizing phase.

• #11 Empyema | Diagnosis & Disease Information – Pulmonology Advisor

  https://www.pulmonologyadvisor.com/ddi/empyema/

  Defined as a collection of pus in the thoracic cavity arising from infection in the pleural space, empyema is most commonly caused by bacterial pneumonia and the resulting accumulation of fluid (parapneumonic effusion) in the pleural space. Approximately 20% to 40% of patients who are hospitalized for pneumonia in the United States (US) develop a parapneumonic effusion, and approximately 5% to 10% of them develop empyema. Up to 65,000 patients are affected by empyema each year in the US. Of those patients, approximately 15% do not survive, and 30% require surgical drainage of the pleural space. […] The development of empyema as a result of pleural infection occurs in 3 stages: Exudative stage (stage I): a small amount of sterile fluid is accumulated in the pleural space following acute inflammatory response […] Fibropurulent stage (stage II): increased neutrophil counts and fibrin deposition due to an infection and collection of pleural fluid in loculated segments […] Organized stage (stage III): fibrin deposits and production of a thick pleural peel lead to restricted lung expansion and chronic empyema.

• #12 Empyema and Parapneumonic Effusions: General Considerations | Iowa Head and Neck Protocols

  https://medicine.uiowa.edu/iowaprotocols/empyema-and-parapneumonic-effusions-general-considerations

  Paraneumonic effusion and empyema are the most common benign conditions involving the pleura. Pneumonias are frequently (2040%) accompanied by reactive parapneumonic effusions containing thin clear fluid. […] In most cases effusions spontaneously resolve, but in some patients, they may persist and become infected (termed complicated effusions). […] In some cases of complicated effusions, flank pus accumulates in the pleural space and such effusion is called empyema. […] Three phases of empyema are classically described: The exudative phase (Stage I) occurs during first 1-2 weeks of illness when the fluid is free-floating within the thorax and associated with inflamed pleura. […] The fibropurulent phase (Stage II) during weeks 1-4 is characterized by purulent effusion and fibrinous exudative deposits on the pleural surface.

• #13 Pediatric empyema – Children’s Health Pulmonology

  https://www.childrens.com/specialties-services/conditions/pediatric-empyema

  Empyema (empyema) in children is a condition that causes pus to pool in the area between the lungs and the chest wall. […] When a child has empyema, pus (fluid filled with immune cells, bacteria and dead cells) pools in the area between the lungs and the inner surface of the chest wall known as the pleural space. […] When a child has pus that gathers in the pleural space, they cant cough it out. Therefore, it must be drained using a needle or surgical procedure. […] There are two types of empyema: […] Simple empyema – When a child first develops empyema, it is known as simple empyema. In this stage of the condition, the pus is free flowing. […] Complex empyema – When a child has had empyema for a period of time and it has advanced, it is known as complex empyema. The inflammation is more severe, and scar tissue may have formed within the chest cavity. With complex empyema, a thick peel over the pleural space known as a pleural peel may develop. When this peel is present, breathing is limited because the lungs cannot expand.

• #14 Empyema | Diagnosis & Disease Information – Pulmonology Advisor

  https://www.pulmonologyadvisor.com/ddi/empyema/

  Defined as a collection of pus in the thoracic cavity arising from infection in the pleural space, empyema is most commonly caused by bacterial pneumonia and the resulting accumulation of fluid (parapneumonic effusion) in the pleural space. Approximately 20% to 40% of patients who are hospitalized for pneumonia in the United States (US) develop a parapneumonic effusion, and approximately 5% to 10% of them develop empyema. Up to 65,000 patients are affected by empyema each year in the US. Of those patients, approximately 15% do not survive, and 30% require surgical drainage of the pleural space. […] The development of empyema as a result of pleural infection occurs in 3 stages: Exudative stage (stage I): a small amount of sterile fluid is accumulated in the pleural space following acute inflammatory response […] Fibropurulent stage (stage II): increased neutrophil counts and fibrin deposition due to an infection and collection of pleural fluid in loculated segments […] Organized stage (stage III): fibrin deposits and production of a thick pleural peel lead to restricted lung expansion and chronic empyema.

• #15 Empyema: Causes, Types, and Symptoms

  https://www.healthline.com/health/empyema

  Empyema can be simple or complex. […] The symptoms of simple empyema include: shortness of breath, dry cough, fever, sweating, chest pain when breathing that may be described as stabbing, headache, confusion, loss of appetite. […] Complex empyema occurs in the later stage of the illness. […] Other symptoms in complex empyema include: difficulty breathing, decreased breath sounds, weight loss, chest pain. […] If the infection continues to get worse, it can lead to the formation of a thick peel over the pleura, called a pleural peel. […] The outlook for empyema with prompt treatment is good. […] However, in people with other conditions that compromise the immune system, empyema can have a mortality rate as high as 40 percent. […] If it’s not treated, empyema can lead to potentially life-threatening complications such as sepsis.

• #16 Empyema vs Pneumonia: Symptoms, Treatment, and Differences

  https://chestsurgeryindia.com/blog/empyema-pneumonia-symptoms-treatment-gurgaon-delhi

  Empyema is pus accumulation in the pleural cavity between the lungs and chest wall. It often develops as a complication of pneumonia or other lung infections. The symptoms of empyema can vary depending on its severity. Common signs include: Persistent cough, often producing yellow or green mucus […] Chest pain, which may worsen with deep breathing or coughing […] Shortness of breath […] Fever and chills […] Fatigue and weakness […] In severe cases, empyema can lead to complications such as pleural effusion, lung abscess, or sepsis if left untreated. […] Yes, pneumonia can progress to empyema if the infection spreads to the pleural cavity and accumulates pus.

• #17 Empyema and Parapneumonic Effusions: General Considerations | Iowa Head and Neck Protocols

  https://medicine.uiowa.edu/iowaprotocols/empyema-and-parapneumonic-effusions-general-considerations

  This stage requires removal of the fibropurulent debris and drain infected fluid. […] The fibrous phase (Stage III) is best avoided by NOT DELAYING drainage during the earlier stages. This phase starts in 4-6 weeks and is characterized by the formation of a thick, fibrous rind (peel or cortex) on the visceral pleural surface of the lung. […] Development of this fibrotic process in the chest is called fibrothorax. Even after drainage of the effusion the lung cannot appropriately expand (trapped lung). […] Complications of empyema tend to occur during the chronic stage and may manifest as bronchopleural fistula, intrathoracic abscess, pericarditis, osteomyelitis. […] The persistence of loculated effusions may depend on their etiology (which bacterial pathogen), appropriateness of antibacterial treatment, and an individual patient’s physiologic and anatomic characteristics. Failure to drain the effusion results in progression of the inflammatory process, entrapped lung, and long-term decreased respiratory capacity.

• #18 Empyema: Causes, Types, and Symptoms

  https://www.healthline.com/health/empyema

  Empyema can be simple or complex. […] The symptoms of simple empyema include: shortness of breath, dry cough, fever, sweating, chest pain when breathing that may be described as stabbing, headache, confusion, loss of appetite. […] Complex empyema occurs in the later stage of the illness. […] Other symptoms in complex empyema include: difficulty breathing, decreased breath sounds, weight loss, chest pain. […] If the infection continues to get worse, it can lead to the formation of a thick peel over the pleura, called a pleural peel. […] The outlook for empyema with prompt treatment is good. […] However, in people with other conditions that compromise the immune system, empyema can have a mortality rate as high as 40 percent. […] If it’s not treated, empyema can lead to potentially life-threatening complications such as sepsis.

• #19 Pediatric empyema – Children’s Health Pulmonology

  https://www.childrens.com/specialties-services/conditions/pediatric-empyema

  Symptoms of simple empyema: […] Chest pain that worsens when breathing […] Confusion […] Decreased appetite […] Dry cough […] Fever […] Headache […] Increased sweating […] Shortness of breath […] Symptoms of complex empyema: […] Chest pain […] Trouble breathing […] Weak breath sounds […] Unexplained weight loss […] In most cases, empyema develops after a child has had pneumonia.

• #20 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-Are-the-Symptoms-of-Empyema.aspx

  The symptoms of empyema typically include general ill-health, unexplained fever, loss of appetite, and weight loss. If a lung infection is present, cough and dyspnoea (difficulty breathing, shortness of breath) may also be present. […] Patients usually present with a one-to-two-week history of symptoms. Within this time frame, they exhibit signs of a productive cough. This is defined as a cough that produces green or rust-colored sputum. […] Another hallmark of empyema is dyspnoea. This occurs in large pleural effusions; the patient may also be breathless if there is associated pneumonia. […] Patients with anaerobic empyemas (those involving anaerobic bacterial infection) can present with a more indolent (slow progression does not pose an immediate threat to health), an illness characterized by weight loss, constitutional upset, and fatigue. […] The most cardinal symptoms include headache, pain, fatigue, loss of appetite, malaise, night sweats, and weight loss.

• #21 Parapneumonic Pleural Effusions and Empyema Thoracis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/298485-clinical

  Clinical manifestations of parapneumonic effusions and empyema largely depend on whether the patient has an aerobic or anaerobic infection. Aerobic infections are more acute in onset and give rise to acute febrile symptoms, whereas anaerobic infections can be indolent in their time course and give rise to nonspecific symptoms with low-grade fever. If fever persists for more than 48 hours after the initiation of antibiotic treatment, a complicating parapneumonic effusion or empyema is likely. […] The clinical presentation of patients with aerobic bacterial pleural-space infection is similar to that of patients with bacterial pneumonia. Patients present with an acute febrile illness with chest pain, sputum production, and leukocytosis. A complicated parapneumonic effusion is suggested by the presence of a fever lasting more than 48 hours after the initiation of antibiotic therapy.

• #22 Parapneumonic Pleural Effusions and Empyema Thoracis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/298485-clinical

  Patients with anaerobic bacterial infections involving the pleural space usually present with a subacute illness. Most of these patients have symptoms persisting for more than 7 days. Approximately 60% of patients have lost weight. Anemia is also common. Patients are likely to have poor oral hygiene and dental infections, chronic alcoholism, or other factors that predispose them to recurrent aspiration.

• #23 Pleural empyema – Wikipedia

  https://en.wikipedia.org/wiki/Pleural_empyema

  Symptoms include fever, dry cough, sweating, difficulty breathing, and unintentional weight loss. […] The elderly often do not have classic symptoms, instead they have anemia and exhaustion. […] When there is inflammation at the pleural space, fluid production is increased. As the disease progresses, bacteria can arrive at the fluid, which creates an empyema. […] Approximately 15 to 40 percent of people require surgical drainage of the infected pleural space because of inadequate drainage due to clogging of the chest tube or loculated empyema. […] Patients should thus be considered for surgery if they have ongoing signs of sepsis in association with a persistent pleural collection despite drainage and antibiotics. […] All patients with empyema require outpatient follow-up with a repeat chest X-ray and inflammatory biochemistry analysis within 4 weeks following discharge. Chest radiograph returns to normal in the majority of patients by 6 months.

• #24 Empyema (Collection of Pus) procedure in Interventional radiology

  https://www.tegbirsidhu.com/empyema-collection-of-pus.php

  Most patients with empyema experience fatigue, fever, chills, sweating and loss of appetite, but elderly patients and those with diabetes may not have specific symptoms. […] If you have pleural empyema, you may experience shortness of breath, coughing and chest pain, whereas if you have gallbladder empyema you are likely to experience nausea, vomiting, constant and severe pain in the right upper or upper middle abdominal area, and pain radiating to the right shoulder blade.

• #25 Persistent hiccups as a rare presenting symptom of empyema: a case report | International Journal of Emergency Medicine | Full Text

  https://intjem.biomedcentral.com/articles/10.1186/s12245-024-00603-7

  Empyema is uncommon owing to antibiotic use but still affects patient health if not treated. Hiccups as the initial symptom of empyema are rare; however, empyema should be considered if a patient has persistent hiccups with unexplained fever. […] We present a case of persistent hiccups, left upper quadrant abdominal pain, and fever on day 1, and total left lung white-out and empyema on day 3. The hiccups resolved gradually after antibiotic treatment and surgical decortication. […] Clinicians should consider the possibility of empyema and conduct a chest computed tomography study if unexplained fever and persistent hiccups coexist. […] The initial presentation of persistent hiccups is very rare in bacterial empyema. […] Symptoms of emerging diseases tend to attract more attention. […] In conclusion, the initial presentation of empyema with hiccups is rare. Clinicians should consider the possibility of empyema and conduct a chest computed tomography study if unexplained fever and persistent hiccups coexist.

• #26 Empyema: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/24269-empyema

  Empyema symptoms are nonspecific and may include: Chest pain or discomfort. Fever. Trouble breathing. Cough. Extreme exhaustion (fatigue). Unexplained weight loss. […] Without proper treatment, empyema can get worse and may be fatal. If you have symptoms of empyema, call a healthcare provider right away. […] Empyema typically develops about four to six weeks after bacteria enter your lungs. […] Empyema isnt common. Most cases dont progress to later stages with early treatment. However, it can be fatal without proper treatment in 5% to 30% of people with empyema and other conditions (comorbidities). The mortality rate is about 40% in immunocompromised people who have empyema.

• #27 Empyema | Diagnosis & Disease Information – Pulmonology Advisor

  https://www.pulmonologyadvisor.com/ddi/empyema/

  While the majority of empyema cases resolve in full recovery, the disease can lead to complications, including the following: Fibrothorax; Pleural thickening which leads to impaired and reduced lung function; Sepsis; Septic Shock; Pneumothorax; BPF; Empyema necessitans an extension of empyema through parietal pleura and into soft tissues of the chest wall; and Death.

• #28 Empyema: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/24269-empyema

  Empyema symptoms are nonspecific and may include: Chest pain or discomfort. Fever. Trouble breathing. Cough. Extreme exhaustion (fatigue). Unexplained weight loss. […] Without proper treatment, empyema can get worse and may be fatal. If you have symptoms of empyema, call a healthcare provider right away. […] Empyema typically develops about four to six weeks after bacteria enter your lungs. […] Empyema isnt common. Most cases dont progress to later stages with early treatment. However, it can be fatal without proper treatment in 5% to 30% of people with empyema and other conditions (comorbidities). The mortality rate is about 40% in immunocompromised people who have empyema.

• #29 Thoracic Empyema – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544279/

  Symptoms tend to evolve as the empyema progresses through its stages: Early symptoms are similar to pneumonia, with common complaints of fever, cough, and pleuritic chest pain. […] As the infection progresses, patients often report worsening chest pain, increased dyspnea, and a productive cough with purulent sputum. […] In chronic or untreated empyema, fibrous septa form within the pleural cavity, encasing the lung and restricting its expansion. […] Empyema has a generally poor prognosis if not treated promptly and aggressively, as untreated or inadequately managed cases can lead to high morbidity and mortality. […] Although most patients recover, outcomes remain challenging, with approximately 20% requiring surgery and a 1-year mortality rate nearing 20%. […] The average hospital stay for empyema is approximately 19 days due to the need for prolonged drainage, antibiotics, and sometimes surgical intervention, with prolonged recovery impacting functional outcomes, especially in older individuals.

• #30 Empyema: Causes, Types, and Symptoms

  https://www.healthline.com/health/empyema

  Empyema can be simple or complex. […] The symptoms of simple empyema include: shortness of breath, dry cough, fever, sweating, chest pain when breathing that may be described as stabbing, headache, confusion, loss of appetite. […] Complex empyema occurs in the later stage of the illness. […] Other symptoms in complex empyema include: difficulty breathing, decreased breath sounds, weight loss, chest pain. […] If the infection continues to get worse, it can lead to the formation of a thick peel over the pleura, called a pleural peel. […] The outlook for empyema with prompt treatment is good. […] However, in people with other conditions that compromise the immune system, empyema can have a mortality rate as high as 40 percent. […] If it’s not treated, empyema can lead to potentially life-threatening complications such as sepsis.

• #31 Empyema: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/24269-empyema

  Empyema symptoms are nonspecific and may include: Chest pain or discomfort. Fever. Trouble breathing. Cough. Extreme exhaustion (fatigue). Unexplained weight loss. […] Without proper treatment, empyema can get worse and may be fatal. If you have symptoms of empyema, call a healthcare provider right away. […] Empyema typically develops about four to six weeks after bacteria enter your lungs. […] Empyema isnt common. Most cases dont progress to later stages with early treatment. However, it can be fatal without proper treatment in 5% to 30% of people with empyema and other conditions (comorbidities). The mortality rate is about 40% in immunocompromised people who have empyema.

• #32 Empyema: Causes, Types, and Symptoms

  https://www.healthline.com/health/empyema

  Empyema can be simple or complex. […] The symptoms of simple empyema include: shortness of breath, dry cough, fever, sweating, chest pain when breathing that may be described as stabbing, headache, confusion, loss of appetite. […] Complex empyema occurs in the later stage of the illness. […] Other symptoms in complex empyema include: difficulty breathing, decreased breath sounds, weight loss, chest pain. […] If the infection continues to get worse, it can lead to the formation of a thick peel over the pleura, called a pleural peel. […] The outlook for empyema with prompt treatment is good. […] However, in people with other conditions that compromise the immune system, empyema can have a mortality rate as high as 40 percent. […] If it’s not treated, empyema can lead to potentially life-threatening complications such as sepsis.

• #33 Pleural Empyema: Causes, Symptoms, and Effective Treatments – Blog – Main

  https://doctor.global/blog/pleural-empyema-causes-symptoms-and-effective-treatments/

  Pleural empyema runs with chills, persistently high fever, profuse sweating, tachycardia, dyspnea, and weakness. […] Acute pyothorax manifests with the development of chills, persistently high (up to 39 C and above) temperature, profuse sweating, increasing dyspnea, tachycardia, cyanosis of the lips, acrocyanosis. […] There is an intense pain syndrome on the affected side; stabbing pain in the chest increases with breathing, movement, and coughing. Pain may irradiate to the scapula and upper half of the abdomen. […] In closed pleural empyema, the cough is dry in the presence of bronchopleural communication, with the separation of large amounts of stinking purulent sputum. […] Patients with pleural empyema are characterized by a forced position half-sitting with support on the arms behind the body. […] The prognosis in pleural empyema is always severe, the lethality is 5-22%.

• #34 Empyema: What It Is, Treatment, and More

  https://www.webmd.com/lung/what-is-empyema

  Empyema is a condition where you have pus between your lung and the membrane surrounding it. Its caused by an infection and can cause symptoms such as pain and shortness of breath. […] As the pus builds up in the pleural space, you will experience a lot of pressure on your lungs, causing pain and shortness of breath. […] If you have empyema, you may experience the following symptoms: Feeling unwell in general, Feeling uneasy, Weight loss, Chest pain that gets worse if you inhale deeply, Chills and fever, Dry cough. […] The symptoms of empyema are similar to those of pneumonia, but those with empyema may have these symptoms for a longer time. […] Generally, empyema wont result in permanent damage to your lungs. But it can be fatal if not treated, particularly if you developed empyema through a fungal infection. […] In general, 20% to 30% of patients with empyema will require surgery or will pass away in the first year after getting empyema.

• #35 Management of empyema: a comprehensive review – Kanai – Current Challenges in Thoracic Surgery

  https://ccts.amegroups.org/article/view/37410/html

  Empyema is the state in which purulent fluid is present in the thoracic cavity. If pleural effusion is purulent, a diagnosis of empyema is given even if a microbial test is not positive. Empyema is associated with high morbidity and mortality. The number of patients with empyema is increasing in both children and adults. Empyema has a 10-20% mortality rate, long hospital stays, and a heavy financial burden. One third of patients being treated require surgical treatment. As pyothorax progresses, pleural effusion increases, bacteria increase, pleural effusion becomes purulent, pH decreases (pH 7.2), LDH increases (LDH 1,000 IU), and glucose is depleted (glucose 40 mg/dL). The initial stage of treatment is only antibiotics, and thoracic drainage is performed according to progression. Intrapleural fibrinolytic therapy or surgical treatment is performed when these treatments do not show improvement or there is further progression. The BTS guidelines indicate that although VATS is useful, it does not address indications or timing of surgery. Surgery is generally indicated to be performed when drainage is ineffective. Empyema in the elderly patient has a poor prognosis, and the surgery intervention is recommended at an early stage with physical strength based on the RAPID score. Surgical treatment for empyema is indicated when there is no improvement by medical treatment. The incidence of empyema after lung cancer surgery was 0.9% and mortality was 11.6%. The frequency of empyema was around 10% before 2000, but around 1% after 2000. Mortality was 14.8% or 22.2% around 1980, but it has been decreasing due to medical progress. […] The RAPID score is very useful as a prognostic score for empyema and is expected to be used in future clinical studies.

• #36 Empyema – MD Searchlight

  https://mdsearchlight.com/lung-disease-respiratory-health/empyema/

  Empyema is a condition that can have symptoms similar to pneumonia. These symptoms include cough, fever, chest pain, and production of sputum. Patients with empyema often experience these symptoms for a pretty long time, with studies showing that on average, patients go to the doctor about 15 days after these symptoms start. […] About 20% to 30% of those affected either dying or needing additional surgery within a year of diagnosis. […] Patients with a score higher than 5 typically have worse outcomes. […] After the acute phase, some patients may develop fibrosis or scarring in the lungs, leading to breathing issues and limited exercise capacity.

• #37 Severe chest infection or chest empyema – Mr. Marco Scarci

  https://marcoscarci.co.uk/severe-chest-infection-or-chest-empyema/

  The three stages of empyema are: 1. Exudative phase: In this stage, fluid accumulates in the pleural space and the pleural membranes become inflamed. This fluid can be clear, yellow, or blood-tinged. 2. Fibrinopurulent phase: In this stage, the fluid becomes thick and pus-like as a result of the accumulation of inflammatory cells, fibrin, and dead tissue. Draining the fluid at this point can be difficult, and antibiotics are typically used to treat the infection. 3. Organizing phase: In this stage, the body’s natural healing process takes over, and the thickened fluid becomes more solid and fibrous. This can make it even more difficult to drain the fluid, and surgery may be needed to remove the affected tissue and promote proper healing. […] The treatment for empyema depends on the severity of the condition and the patient’s response to the treatment. The most common treatment is a combination of antibiotics and drainage of the infected fluid from the affected area. The duration of treatment can vary, but it typically lasts between 4 to 6 weeks. In some cases, surgery may be necessary to remove the infected tissue and promote healing.

• #38 Empyema – O2 Healthcare Group

  https://o2healthcaregroup.com/cardiothoracic/empyema/

  Treatment for empyema depends on its severity and may include: Antibiotics: These are needed for treating the underlying infection. Broad-spectrum antibiotics are often started immediately, and adjustments are made based on culture results. Drainage: If fluid accumulation in the pleural cavity is significant, a chest tube may be placed to facilitate continuous drainage of pus and fluid. This procedure, known as thoracostomy, involves inserting a flexible tube into the pleural space through a small incision in the chest wall. By allowing the infected fluid to escape, drainage can help relieve symptoms such as chest pain and difficulty breathing, while also improving lung function and reducing the risk of further complications. Video-assisted thoracoscopic surgery (VATS): When drainage alone is ineffective or if the empyema is complicated, video-assisted thoracoscopic surgery (VATS) may be performed. This minimally invasive surgical technique involves the use of a small camera (thoracoscope) and instruments inserted through tiny incisions in the chest wall. VATS allows surgeons to directly visualise the pleural cavity, facilitating the removal of thickened pleura, necrotic tissue, or residual pus. The procedure is associated with reduced recovery times, less postoperative pain, and shorter hospital stays compared to traditional open surgery, enhancing overall recovery. Decortication: In cases where the pleura become fibrous and restrict lung expansion, surgical decortication may be necessary. This procedure involves surgically removing the fibrous layer surrounding the lungs (the pleura) to allow for better lung expansion and function. By removing the thickened tissue, decortication can help restore normal lung mechanics and improve the patient’s ability to breathe. This procedure is often considered when other treatments have failed, and the patient’s quality of life is significantly impacted by restrictive lung disease due to empyema.

• #39 Empyema: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/24269-empyema

  Empyema symptoms are nonspecific and may include: Chest pain or discomfort. Fever. Trouble breathing. Cough. Extreme exhaustion (fatigue). Unexplained weight loss. […] Without proper treatment, empyema can get worse and may be fatal. If you have symptoms of empyema, call a healthcare provider right away. […] Empyema typically develops about four to six weeks after bacteria enter your lungs. […] Empyema isnt common. Most cases dont progress to later stages with early treatment. However, it can be fatal without proper treatment in 5% to 30% of people with empyema and other conditions (comorbidities). The mortality rate is about 40% in immunocompromised people who have empyema.

• #40 Empyema

  https://www.nhs.uk/conditions/empyema/

  Empyema is a serious condition that requires treatment. It can cause fever, chest pains, breathlessness and coughing up mucus. […] 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. […] 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.

• #41 Empyema | nidirect

  https://www.nidirect.gov.uk/conditions/empyema

  An empyema can be distressing and uncomfortable, causing: a fever and night sweats, a lack of energy, difficulty breathing, weight loss, chest pain, a cough – which can involve coughing up mucus containing pus. […] Empyema can worsen to become many more pockets of pus, with thick deposits coating the outer layer of the lungs. These deposits prevent the lungs expanding properly. […] An empyema is usually suspected when a person with severe pneumonia does not improve with treatment and they start to show some of the symptoms.

• #42 Empyema – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/1008

  Empyema is defined as the presence of pus in the pleural space. […] In patients with symptoms and signs of infection and a significant pleural effusion, thoracentesis (pleural aspiration) must be performed urgently. […] If empyema or a complicated parapneumonic effusion is diagnosed, a chest drain must be inserted urgently. […] A prolonged course of antibiotics is also required. […] If patients do not improve with antibiotics and drainage of the pleural space, surgery or intrapleural enzyme therapy should be considered. […] Mortality is approximately 15% to 20%. […] Key diagnostic factors include presence of risk factors, recent pneumonia, constitutional symptoms, pyrexia and rigors, dullness to percussion, reduced breath sounds and reduced vocal resonance, and signs of sepsis. […] Other diagnostic factors include subacute presentation, productive cough, pleuritic chest pain, dyspnoea, and recent instrumentation of the pleural space.

• #43 Thoracic Empyema – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544279/

  Thoracic empyema, characterized by the presence of purulent fluid in the pleural space, remains a significant clinical challenge with considerable morbidity and mortality. This condition typically arises as a complication of pneumonia, chest trauma, or surgery and is associated with the complex pathophysiologic processes of infection and inflammation. Early diagnosis and aggressive management, including antimicrobial therapy, drainage procedures, and sometimes surgery, are critical for favorable outcomes. […] Stemming from multifactorial etiologies, empyema progresses through distinct stages that clinicians must recognize for effective management. […] Prompt diagnosis and intervention are crucial for improving patient outcomes, as treatment hinges on integrating medical and surgical strategies to eradicate the infection and facilitate lung reexpansion.

• #44 Parapneumonic Pleural Effusions and Empyema Thoracis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/298485-clinical

  Patients with anaerobic bacterial infections involving the pleural space usually present with a subacute illness. Most of these patients have symptoms persisting for more than 7 days. Approximately 60% of patients have lost weight. Anemia is also common. Patients are likely to have poor oral hygiene and dental infections, chronic alcoholism, or other factors that predispose them to recurrent aspiration.

• #45 Pleural empyema – Wikipedia

  https://en.wikipedia.org/wiki/Pleural_empyema

  Symptoms include fever, dry cough, sweating, difficulty breathing, and unintentional weight loss. […] The elderly often do not have classic symptoms, instead they have anemia and exhaustion. […] When there is inflammation at the pleural space, fluid production is increased. As the disease progresses, bacteria can arrive at the fluid, which creates an empyema. […] Approximately 15 to 40 percent of people require surgical drainage of the infected pleural space because of inadequate drainage due to clogging of the chest tube or loculated empyema. […] Patients should thus be considered for surgery if they have ongoing signs of sepsis in association with a persistent pleural collection despite drainage and antibiotics. […] All patients with empyema require outpatient follow-up with a repeat chest X-ray and inflammatory biochemistry analysis within 4 weeks following discharge. Chest radiograph returns to normal in the majority of patients by 6 months.

Zobacz więcej