Empyema causes pus to develop in the pleural space in your chest. The most common cause is pneumonia. Healthcare providers can diagnose it with imaging and blood tests. Antibiotics can treat most cases. But a provider may need to drain pus with a needle or surgery.
Advertisement
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Image content: This image is available to view online.
View image online (https://my.clevelandclinic.org/-/scassets/images/org/health/articles/24269-empyema)
Empyema is an infection in which pus develops in your pleural space. Your pleural space is a hollow area (cavity) between your lungs and underneath your chest wall.
Advertisement
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Empyema (pronounced “em-pie-EE-muh”) causes symptoms that affect your chest. Without proper treatment, your symptoms may get worse and can be deadly. In the U.S., empyema affects up to 65,000 people each year.
Other names for empyema include:
There are three stages of empyema development:
Empyema symptoms are nonspecific. That means they’re too general for your provider to make a diagnosis without testing. They may include:
Empyema usually develops when an infection within your lung spreads to the area around/outside your lung. The most common infection that causes it is pneumonia.
Advertisement
Other causes may include:
If empyema develops, it’s typically about four to six weeks after bacteria enter your lungs.
Anyone can get empyema. But you’re at a higher risk if you have conditions like:
You may also be at risk if you:
Empyema complications may include:
Your healthcare provider will:
If they suspect empyema, they’ll recommend tests to help confirm a diagnosis. These may include:
Treatment includes removing pus from your pleural space and treating the infection. Providers commonly prescribe antibiotics to kill the infection.
In the early stages of empyema, they’ll do a thoracentesis procedure to remove pus. They’ll numb the area with a local anesthetic. Then, they’ll use a catheter device to withdraw the pus. Often, they’ll place a tube into the chest and leave it there for several days to allow continuous drainage. If drainage isn’t enough, your provider may inject medications into your chest through the tube to break up the pus. This usually requires a hospital stay.
Advertisement
In the later stages, your provider may need to perform a more invasive procedure to remove fibrous tissue from your lungs and chest wall. These may include:
Your healthcare provider may prescribe:
Antibiotics usually take two to six weeks to work. It’s important to take your full course of antibiotics, even if you feel better. If you don’t, the infection may come back and be harder to treat.
After thoracentesis, you may feel sore for a few days or up to a week.
If you need surgery, it may take between four and six weeks to make a full recovery.
It’s important to see your provider if you have symptoms of empyema and are at a higher risk of getting it.
During your appointment, you may want to ask questions like:
With early diagnosis and treatment, most empyema cases don’t progress to later stages. Most people make a full recovery.
Advertisement
Without proper treatment, your risk of permanent lung damage increases. It’s also more likely to be fatal, especially if you have empyema along with other conditions (comorbidities). This includes a weakened immune system.
No, it isn’t chronic obstructive pulmonary disease (COPD). “COPD” is an umbrella term for various lung diseases. These include chronic bronchitis and emphysema. If you have COPD, providers are more likely to see an infection like empyema as a symptom than if you didn’t have COPD.
Pneumonia is an infection in one or both of your lungs. Its causes include bacteria, viruses and fungi. You can cough out infected phlegm if you have pneumonia.
Empyema is in your pleural space. The bacteria that cause pneumonia can cause empyema. You can’t cough out pus if you have empyema. You must clear the pus with antibiotics, or a provider must use a procedure to drain it.
Emphysema is a lung disease that results from damage to the fragile air sacs (alveoli) in your lungs. Smoking is the main cause of emphysema.
Pleural effusion (water on the lungs) is a build-up of excess fluid between the thin membranes of your lungs and pleural space.
A parapneumonic effusion is a type of pleural effusion. It develops due to pneumonia. It can progress to empyema.
Advertisement
Chest pain, fever, fatigue, a cough — these are symptoms of many kinds of conditions. It can be easy to dismiss how you’re feeling as a common illness or infection. But if a healthcare provider recently diagnosed you with pneumonia or you experienced chest trauma, these may be symptoms of empyema. You should quickly schedule an appointment with your provider to help keep it from progressing. They can also address any of your questions or concerns.
Sign up for our Health Essentials emails for expert guidance on nutrition, fitness, sleep, skin care and more.
Learn more about the Health Library and our editorial process.
Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.
Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.
Breathing issues can affect your life in many ways. Cleveland Clinic’s respiratory therapy program treats your symptoms so you can feel better day to day.
