empyema
Pronunciation: em-py-EE-mah
Collection of infected fluid (pus) in the pleural space, a serious complication of pneumonia requiring drainage procedures.
Full Definition
Empyema is defined as the presence of grossly purulent fluid in the pleural space or pleural fluid with positive bacterial culture or Gram stain. It represents a serious complication of pneumonia, occurring in approximately 1-2% of pediatric pneumonia cases. The condition typically develops when bacterial infection spreads from the lung parenchyma to the pleural space, most commonly caused by Streptococcus pneumoniae, Staphylococcus aureus, or Streptococcus pyogenes. Clinical presentation includes persistent fever, chest pain, and respiratory distress despite antibiotic treatment for pneumonia. Diagnosis requires chest imaging and pleural fluid analysis. Treatment involves prolonged antibiotic therapy combined with drainage procedures such as chest tube insertion, video-assisted thoracoscopic surgery (VATS), or fibrinolytic therapy.
Usage
Usage note: Distinguish from simple pleural effusion; empyema specifically refers to infected pleural fluid.
In Context
- "Pleural fluid analysis confirmed empyema with gram-positive cocci on microscopy." — Pulmonology consultation
- "The patient required VATS decortication for organized empyema following pneumonia." — Surgical procedure note