User:Mr. Ibrahem/Pleural empyema

Pleural empyema is a collection of pus in the space around the lungs (pleural cavity). Symptoms may include cough, fever, shortness of breath, sputum production, and pleuritic chest pain. Complications may include fibrothorax or respiratory distress. It is a type of pleural effusion.

It most commonly occurs as a complication of pneumonia. Other causes include esophageal rupture, chest injury, and chest surgery. Risk factors include diabetes and alcoholism. The underlying mechanism most commonly involves a bacterial infection with Streptococcus or Staphylococcus. Diagnosis is generally based on medical imaging followed by thoracentesis.

Treatment is generally a combination of antibiotics and drainage. Antibiotics may include a combination of ceftriaxone and metronidazole for 2 to 6 weeks. If MRSA is a concern vancomycin may be added. A chest tube or surgery may be used for drainage. Despite treatment up to 30% of people require further surgery or die within a year. In the United States about 32,000 cases occur per year. It has been described since the time of Hippocrates.