[7] Pleural Empyema Flashcards
What is pleural empyema?
Collection of pus in the pleural cavity caused by microorganisms, usually bacteria
What are the stages of pleural empyema?
- Exudative
- Fibrinopurulent
- Final organising stage
What happens in the exudative stage of pleural empyema?
There is an increase in pleural fluid, with or without the presence of pus
What happens in the fibrinopurulent stage of pleural empyema?
Fibrous septa form localised pockets
What happens in the final organising stage of pleural empyema?
There is scarring of the pleura membranes with a possible inability of the lung to expand
What are the causes of pleural empyema?
- Pneumonia
- Bronchiectasis
- Pulmonary infarction
- Chest surgery
- Endoscopy
- Serious injury to chest
- Aspiration
- Tuberculosis
What are the risk factors for pleural empyema?
- Diabetes
- Immunocompromised
- Acid reflux
- Alcohol or drug use
What are the symptoms of pleural empyema?
- Fever and night sweats
- Lack of energy
- Difficulty breathing
- Weight loss
- Chest pain
- Cough
What is involved in the diagnosis of pleural empyema?
- Sputum sample
- Blood sample
- X-ray
- Ultrasound
How is pleural empyema treated?
- IV antibiotics
- Pleural fluid drainage
What is proven empyema an indication for?
Prompt chest tube drainage
What can be used if a chest drain is not suitable in pleural empyema?
A stoma
What is involved in stoma treatment in pleural empyema?
An opening is made in the chest, and a bag is placed over the stoma to collect the pus. The bag is worn on the body
What is the advantage of a stoma over a chest drain?
It may be more discrete and less interfering than a chest drain
What % of people require surgical drainage of pleural empyema?
15-40%
