Treatment of Pleural Empyema (abscess)

About the disease

Pleural empyema is a collection of pus in the area located between the lungs and the chest wall. According to Healthline, the most common cause of pleural empyema is pneumonia. In such case pleural empyema develops as a complication of an untreated infection. A person is unable to cough out the pus and the only way to get it out of the pleural space is by medical drainage.

If a person develops pneumonia, he/she needs to fight the infectious bacteria completely to avoid development of complications later on. A person can develop pneumonia as a result of severe cold or close contact with another infected person. Pneumonia is not the only cause of pleural empyema. It can also develop as a result of previous chest surgery or trauma, that`s why a person needs to be checked up regularly after undergoing the surgery or having an accident.

Generally, there is some natural amount of fluid in the pleural area required for proper functioning of the lungs. In case a person gets infection, pleural area can start to produce excessive amount of fluid, which can later on thicken and also turn into pus. Pleural empyema can lead to development of respiratory problems and also cause damage to the lung lining, that's why it is important to treat this condition on time.

Good news is that pleural empyema is very uncommon. It develops in only 1% of people who had pneumonia. Also, this condition is most common among children and elderly as their immune system is weaker and more compromised  during infections. People who have weak immune system due to other medical conditions, such as diabetes or HIV are also at great risk of developing pleural empyema should they contract pneumonia. Alcoholism and smoking are the risk factors as well.

Symptoms

• Dry cough
• Chest pain
• Fever
• Shortness of breath
• Chills
• Night sweats
• Weight loss
• Weakness
• Fatigue

Diagnosis

• During a general examination the doctor will examine the medical history of the patient to determine if he/she had pneumonia in the past.
• The doctor will also listen to the patient`s heart with the stethoscope to determine if there are any abnormalities, such as murmur.
• Imaging tests, such as an X-ray or CT scan, are helpful in determining if there is an excess of fluid in the lungs. These tests can also show the exact location of the excess fluid collection which will be helpful in further treatment. An ultrasound can be used for the same purposes as well.
• A blood test is ordered to determine the exact type of  bacteria which caused the infection in the first place. The test will also be helpful in further treatment plan.

Treatment

• Antibiotics may be prescribed to kill the bacteria which caused an infection if the bacteria is still active.
• Pleurectomy with lung decortication is a surgery used to drain the pus and also normalize the normal functioning of the pleural space.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko