• Tuesday July 7,2020


An empyema is a purulent fluid accumulation in a natural cavity of the body. Particularly affected is the lungs. In most cases, empyema can be treated well; The disease may be life-threatening, especially in the lungs.

What is an empyema?

An empyema can express itself through various symptoms. Sore throat, cough and sputum are typical for the disease. The secretions are usually brownish-green and have an unpleasant odor.
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The term empyema is understood by physicians to mean a build-up of purulent fluid in a body cavity. The name means in Greek as pus forming. Most of the time an empyema develops as a result of tissue inflammation, which subsequently leads to the typical formation of fluid.

In many cases, the lungs are affected, more specifically the cavity around the lungs. This condition is also known as thoracic or pleural empyema and is called in professional circles Empyema thoracis. In rarer cases, the gallbladder or the pelvic cavity may be affected by fluid accumulation. An empyema should always be treated medically as it can lead to death of the patient without prompt and appropriate therapy.


Responsible for an empyema is a bacterial infection. In the lung, Haemophilus influenzae, which causes diseases such as bronchitis or pneumonia, Streptococcus pneumoniae which causes meningitis of the lungs and meninges, and Staphylococcus aureus, pneumonia and sepals, but also boils, are particularly common in the lungs caused.

The latter is the causative agent of fluid accumulation in almost 90% of all cases involving infants and toddlers. If the empyema is in the pelvis, the bacterium Pseudomonas aeruginosa is usually responsible. Especially in elderly or chronically ill patients, it is not uncommon to find the bacterium Klebsiella pneumoniae.

The pathogens affect the tissue, which covers the lungs, for example. As a protective reaction, the body repels dead cells. At the same time pus and fluids form, which together with the dead cells fill the body cavities and lead to an empyema.

Symptoms, complaints & signs

An empyema can express itself through various symptoms. Sore throat, cough and sputum are typical for the disease. The secretions are usually brownish-green and have an unpleasant odor. They occur especially in the morning and cause the characteristic rattling or boring breath sounds. Most are shortness of breath and fatigue added.

In the course of the physical and mental performance decreases, the person concerned is usually no longer able to cope with everyday tasks. Ingestion of the secretions can cause abdominal pain, nausea and vomiting. Also, diarrhea can not be ruled out. Accompanying this usually occurs also a bad breath. Many sufferers suffer from fever, which is characterized by circulatory problems, sweating and an increasing feeling of illness.

If an empyema is not treated, the infection may spread to other organs. If it spreads to the heart, it can lead to cardiovascular complaints, heart failure and other serious symptoms and complications. Infestation of the brain can lead to encephalitis or meningitis. In general, carryover of the infection is life-threatening and causes general symptoms such as high fever and coma. In extreme cases, the patient dies.

Diagnosis & History

Pulmonary emphysema can be detected by the attending physician, inter alia, by listening to the lungs and tapping the chest and back. If a patient comes to the doctor with symptoms such as shortness of breath, cough, chest pain, fever and tiredness, this also indicates a fluid accumulation.

A bad breath and a brownish-green expectoration can be further hints. An X-ray and an ultrasound scan make the empyema clearly visible. The condition caused by an infection should always be treated medically, otherwise the infection can spread to the heart or brain. In these cases, there is high fever, bloody sputum, and finally coma and death of the patient.

When should you go to the doctor?

If there are problems with breathing, this is worrisome. A visit to a doctor is necessary if the symptoms persist for a long time or increase in intensity. In case of shortness of breath or lack of breathing, a doctor must be consulted. There is a continuous shortage of the organism, which can end in a life-threatening condition. For sleep disorders, concentration problems or disorders of attention, a doctor is needed.

Tachycardia, increased blood pressure and problems with the heart rhythm must be examined and treated by a doctor. Without medical treatment, acute conditions can occur which can lead to lifelong impairments. In case of fever or prolonged tiredness despite sufficient sleep, a doctor is needed. Pain in the chest or in the abdominal region must be clarified and treated. If the sensation of pain increases, a doctor should be consulted as soon as possible.

Before taking an analgesic drug, it is advisable to consult a physician to clarify possible side effects and risks. In case of persistent coughing, noticeable breath odors, or recurrent expectoration, seek medical attention. In case of strange respiratory sounds or inability to inhale deeply, a doctor should be consulted. If it comes to a bloody sputum when coughing an emergency doctor is to call because there is a critical health condition.

Treatment & Therapy

If an emphysema has been clearly diagnosed, the treating physician must act promptly and initiate therapy. This usually consists of a combination of medication and surgery. During the operation, the accumulated fluid can be removed, which significantly relieves the pressure and makes it easier to breathe during a pulmonary empyema.

In addition, the organs regain more space in the body. If the infection is still at an early stage, the fluid can be removed by a so-called thoracocentesis. This is a hollow needle, which is inserted into the chest cavity. Once the empyema has progressed, the surgeon must open the chest and drain the fluid through a tube. If the tissue is already severely affected, it must also be removed surgically.

Then the lungs can develop better and fill the chest as usual. In addition to surgery, the bacterial infection must be treated. For this purpose, antibiotics, especially penicillin, are administered.

These should be given for at least two weeks to ensure that all bacteria have been killed. Mostly, the medication is given intravenously, as it allows them to work faster and more effectively. The earlier the empyema is detected, the more effective the drug treatment.

Outlook & Forecast

It is very difficult to give a precise prognosis and prognosis, as medical treatment can positively influence the course of the disease. In most cases, such empyema is associated with bursitis. Normally, such an inflammation stops within a few days. The pus production diminishes, so that an uncomplicated healing process is to be expected. The prospect of a complete cure looks very good.

However, if pus formation does not regress, but increases, then a more difficult course of the disease is to be expected. Due to the long-lasting production of pus bacteria can form, which can cause a heavy inflammation.

If such a disease remains without any treatment, then it is likely that the disease will be much more difficult. Under certain circumstances, an abscess may form. If, in such a case, a visit to the doctor is not made, it can even lead to blood poisoning in the worst case scenario.


Because empyema is a bacterial infection, prevention is not possible. A healthy lifestyle strengthens the immune system and can improve the general condition of the individual. However, this does not rule out that it can still come to an empyema. If it comes to the first symptoms, sufferers and family members should visit a doctor as soon as possible.

If the fluid accumulation is detected at an early stage, it may be possible to treat it purely medicinally and prevent deterioration of the condition. If symptoms such as shortness of breath, fever or a conspicuous expectoration occur, it is advisable to consult the doctor in case of doubt and to clarify the causes of the symptoms.


In the case of empyema, first of all, early treatment is very important so that there are no further complications or, in the worst case, death of the person affected. The sooner the disease is recognized, the better the disease usually goes. Therefore, in the foreground especially the early detection of empyema.

In general, however, the measures or options for aftercare are very limited or not really necessary. The treatment itself is carried out with the help of an operative procedure. After this procedure, the affected person should under no circumstances be physically exhausted or active. Of stressful or sporting activities is to be foreseen in any case, so as not to unnecessarily burden the body.

Furthermore, antibiotics are often useful after the procedure to prevent infections. In this case, antibiotics should not be taken with alcohol, otherwise their effect is significantly reduced. In case of doubt or ambiguity, a doctor can always be contacted. In most cases, empyema also does not reduce life expectancy if treatment is initiated early. The lungs should not be unnecessarily burdened after the procedure, so that is also foreseeable from smoking.

You can do that yourself

An empyema is a serious condition that should not be treated with home remedies or over-the-counter medicines alone. The best form of self-help is to see a doctor in a timely manner and follow his instructions strictly. Otherwise serious complications such as blood poisoning can occur. A lung empyema can even be fatal.

If an empyema is discovered early, it can usually be treated with antibiotics before complications arise. The antibiotics must be taken as prescribed by the doctor. Under no circumstances may an antibiotic treatment be interrupted or stopped prematurely.

This also applies if side effects show up. These side effects may be treated by a patient, after consultation with the doctor, but also with mild home remedies. Antibiotics kill not only pathogens but also beneficial intestinal bacteria, often resulting in severe diarrhea. Probiotic foods, especially yoghurt, can help the intestine to recover.

Women often suffer from infection of the vagina with yeast during or shortly after treatment with antibiotics. This side effect can be prevented by the use of lactic acid suppositories, which are available for free sale in the pharmacy.

A healthy lifestyle supports the body's defenses, which accelerates the healing of empyema.

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