Empyema

Question 1

What is a pleural empyema?

Answer 1

A collection of pus in the pleural space.

Question 2

Causes

Answer 2

• Complication of pneumonia.

- Iatrogenic.

Question 3

Symptoms

Answer 3

Recurrent fever, productive cough, pleuritic chest pain.

Question 4

Signs

Answer 4

Dullness to percussion, decreased breath sounds and decreased vocal resonance.

Question 5

Investigations

Answer 5

CXR, WBC, CRP, Thoracentesis, ultrasounds

Question 6

CXR

Answer 6

Will show a persisting pleural effusion D shape

Question 7

WBC

Answer 7

WBC count raised

Question 8

CRP

Answer 8

Raised

Question 9

Thoracentesis

Answer 9

Frank pus in Thoracentesis.

• pH <7.2
• Decreased glucose.
• Increased LDH

Question 10

Mortality of empyema

Answer 10

20%

Question 11

Treatment of empyema

Answer 11

IV Broad spectrum antibiotic (amoxicillin) then oral co-amoxiclav for 5 weeks.

Chest tube drainage.

Supportive care.