What is an Empyema?

The word empyema comes from the Greek word “pyon,” meaning pus. The famous Greek philosopher Aristotle had referred to an empyema and the chest tube procedure used to drain it in his works dating as far back as 300 B.C. An empyema can sometimes be a complication from pneumonia, usually from a bacterial strain such as Streptococcus.(Visit http://www.medterms.com/script/main/art.asp?articlekey=3230 for more information.)

An empyema is a collection of pus in the pleural cavity of the lung, located between the outer surface of the lung and the chest wall. It differs from an abscess in that an empyema forms within a naturally existing cavity of the body, while an abscess forms in a newly formed cavity.(Please visit Winkipedia at http://en.wikipedia.org/wiki/Empyema for more information.)

An empyema can also be caused by other factors, such as a chest trauma in which the chest was penetrated, a rupture of the esophagus, complications from lung surgery after a thoracentesis procedure or following a chest tube placement. Aside from Streph pneumonia, other medical conditions such as Staphylococcus aureus bacterial infections or Haemophilus influenza (H. flue) type B may cause an empyema. (See http://emedicine.medscape.com/article/807499-overview for more information.)

The empyema has three phases of formation. The first is the accumulation of pus, followed by the creation of a pocket of pus that may resemble a grape in formation, and finally, becoming trapped in the lung and scarring. These three phases are known as the exudative, fibrinopurulent and organizing phases.

Empyema can many times be treated with antibiotics after it is determined which antibiotics the infection will respond to best. Chest tube drainage is usually done to drain the empyema and works well if the pus is free flowing. In other , more rare cases, surgery may be necessary to clean out the area and remove the “pleural peel” (See http://emedicine.medscape.com/article/1001747-treatment for more details.)

I had never heard of an empyema until my usually quite healthy son had a severe case of streph pneumonia at age four. He became very ill very quickly and had been hospitalized for eight days. He seemed to improve but suddenly took a turn for the worse. He was transferred by ambulance (with me right there with him)to a children’s hospital where they inserted a chest tube. After the empyema refused to drain properly, he was taken to surgery where the pleural cavity of his lung was cleaned out. I was told the pus had become a thick consistency, much like that of oatmeal, which is why it would not drain adequately. After a grand total of 16 days in the hospital, he was able to come home.

Needless to say, this was to date, the scariest experience of my life. I am happy to report that my son is now a healthy, robust 21-year-old in his fourth year of college.


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