Empyema is an accumulation of pus in the pleural space, the cavity between the lungs and the inner surface of the chest wall. Infection within the lung (pneumonia) can be coughed out. Infection in the pleural space (empyema) cannot be coughed out and must be drained by a needle or surgery. Sometimes called pyothorax or purulent pleuritis, empyema develops when bacteria invades the pleural space. A pleural effusion or “water on the lung” can develop into an empyema, a more serious and life-threatening condition. Empyema is typically caused by an infection such as pneumonia or following surgery.
Chronic infections of the lungs from pneumonia, tuberculosis, non-tuberculous mycobacterial (NTM) infections and influenza as well as fungal and bacterial infections can also be extremely serious, leading to millions of deaths worldwide annually.
The Lung Center at Brigham and Women’s Hospital (BWH) provides specialized evaluations and innovative treatment for people suffering from empyema and lung infections. Our board-certified surgeons perform minimally invasive surgical techniques such as thoracoscopic drainage with decortication using video assisted thoracic surgery (VATS), to remove infected tissue and relieve symptoms with minimal discomfort.
Factors that put a person at risk for developing infections of the pleura (empyema) or infections of the lung include:
Empyema starts as thin infected tissue that prevents the lung from working. After a few days, this fluid becomes thick (gelatinous), and must be scraped out. If left inside, the gelatinous material turns to a scar on the lung like the peel of an orange. The last stage, pneumothorax, can cause permanent disability.
Signs and symptoms of empyema and lung infections include:
Your BWH thoracic surgeon may conduct the following diagnostic tests and procedures after noticing an abnormal sound when listening to your chest with a stethoscope:
The goal of treatment is to cure the infection by removing pus and affected tissue, draining the pleura or lung and reduce symptoms. Treatment methods include:
When you become a patient of The Lung Center, you will receive a thorough diagnostic examination and receive clinically-proven treatment by a board-certified thoracic surgeon who specializes in infections of the pleura (empyema) and lung. Our goal is to alleviate or eliminate symptoms and prevent loss of lung function so patients can confidently resume everyday activities.
You will be taken care of in the operating room by surgeons, anesthesiologists and nurses who specialize in surgery for patients with thoracic problems. After surgery you will go to the recovery room (Post Anesthesia Care Unit) and then you will be transferred to the Thoracic Intermediate Care Unit (TICU) where you will receive specialized comprehensive care by an experienced medical and nursing staff to get you better rapidly.
Empyema and lung infections patients benefit from the wide range of specialists at The Lung Center, including thoracic surgeons, oncologists, pulmonologists, cardiovascular medicine physicians and imaging experts. This collaboration ensures comprehensive diagnosis and targeted treatment for patients.
Any surgery recommended will be performed by an experienced, board-certified surgeon, in collaboration with the treatment team including nurses and physician assistants, all of whom specialize in taking care of patients with disorders of the lung.
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