Lung Empyema

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Pus is a fluid filled with immune cells, dead cells, and bacteria. Empyema is a condition in which pus accumulates in the area between the lungs and the inner surface of the chest wall. This area is known as the pleural space. Empyema, also called pyothorax or purulent pleuritis, usually develops after pneumonia, which is an infection of the lung tissue. Pus in the pleural space can’t be coughed out. Instead, it needs to be drained by a needle or surgery.

 

THE SYMPTOMS OF LUNG EMPYEMA

  • Pain in chest (worsens when you breathe in deeply)
  • Dry cough
  • Sweating excessively (especially night sweats)
  • Fever and chills
  • General discomfort, uneasiness or ill feeling (malaise)
  • Shortness of breath
  • Unintentional weight loss

 

TREATMENTS TO TREAT THIS CONDITION 

The goal of the treatment is to remove the pus, drain the fluid from the pleura and treatment of the infection. Underlying infection is treated with antibiotics. Depending on the type of bacteria that’s causing the infection, different antibiotics will be prescribed.

Draining the pus is the next step. The method used will depend on what stage the empyema is at.

  • Simple Empyema: A needle is inserted into the pleural space to drain out the fluid in simple cases. This is known as percutaneous thoracentesis.
  • Complex Empyema: A drainage tube is used to drain the pus in later stages. This is normally performed under general anesthesia in an operating room.

Thoracostomy

A plastic tube will be inserted into your chest (between two ribs) to a suction device and the fluid will be removed. A medication may also be injected to help drain out the fluid.

Open decortication

The pleural peel will be peeled away by your surgeon and this will help prevent permanent disability.

Video-assisted thoracoscopic surgery

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique used to diagnose and treat problems in your chest. During a video-assisted thoracoscopic surgery procedure, a tiny camera (thoracoscope) and surgical instruments are inserted into your chest through several small incisions. The thoracoscope transmits images of the inside of your chest onto a video monitor, guiding the surgeon in performing the procedure.

 

HOW IS THIS CONDITION DIAGNOSED?

  • Physical examination: A complete medical history and physical examination will be conducted. A stethoscope may be used to detect abnormal sounds. Decreased breath sounds or an abnormal sound when listening to the chest may be noted down.
  • Chest X-rays and CT scans: Reveal if there is fluid in the pleural space
  • Ultrasound: To determine the amount of fluid and the exact location
  • Blood tests: To check white blood cell count and C-reactive protein and also to identify the particular bacteria that’s causing the infection. When you have an infection, the white blood count will be elevated.
  • Thoracentesis: A sample of fluid is injected into the pleural space through a needle that’s inserted through the back of your ribcage. The fluid will then be analyzed to search for bacteria, protein, and other cells.

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