Pleural Empyema

Pleural spaces are seen as black, curving lines wrapping around lungs

Pleural empyema refers to the infection of pleural space, which is located between two lining sheets that wrap around lungs. In healthy people, this pleural space is deflated and does not contain fluid. This space, however, may expand and contain abnormal fluid which usually leaks in from infected or injured lungs. If pus or bacteria are found in this abnormal fluid, pleural empyema is diagnosed.

Arrows point at pleural empyema seen on a chest CT scan

Pleural empyema can become deadly if left untreated.

Treatment requires the placement of a chest tube which helps drain pus or infected fluid. Also, 4-6 weeks of antibiotics that help kill both aerobes and anaerobes are required.

In some cases empyema walls become thickened scars that prevent lungs from expanding properly, even after infection is successfully treated. These conditions are called "trapped lungs" and treating doctors may recommend decortication.