Large or rapidly expanding pleural infection with lung compression and mediastinal shift
Rarely complicated by cardiac arrest
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Garvia V et al: Empyema 2020
Godfrey MS et al: Medical and surgical management of empyema. Semin Respir Crit Care Med. 40(3):361-74, 2019
Shaw JA et al: Pleural tuberculosis: a concise clinical review. Clin Respir J. 12(5):1779-86, 2018
Santamarina MG et al: Multidetector CT for evaluation of the extrapleural space. Radiographics. 37(5):1352-70, 2017
Shen KR et al: The American Association for Thoracic Surgery consensus guidelines for the management of empyema. J Thorac Cardiovasc Surg. 153(6):e129-46, 2017
Wongwaisayawan S et al: Emergency thoracic US: the essentials. Radiographics. 36(3):640-59, 2016
Helm EJ et al: Imaging of the pleura. J Magn Reson Imaging. 32(6):1275-86, 2010
Kraus GJ: The split pleura sign. Radiology. 243(1):297-8, 2007
Chae EJ et al: Radiographic and CT findings of thoracic complications after pneumonectomy. Radiographics. 26(5):1449-68, 2006
Qureshi NR et al: Imaging of pleural disease. Clin Chest Med. 27(2):193-213, 2006
Wurnig PN et al: Video-assisted thoracic surgery for pleural empyema. Ann Thorac Surg. 81(1):309-13, 2006
Bramley D et al: Tension empyema as a reversible cause for cardiac arrest. Emerg Med J. 22(12):919-20, 2005
Cheng G et al: A retrospective analysis of the management of parapneumonic empyemas in a county teaching facility from 1992 to 2004. Chest. 128(5):3284-90, 2005
Falguera M et al: Etiology and outcome of community-acquired pneumonia in patients with diabetes mellitus. Chest. 128(5):3233-9, 2005
Misthos P et al: Early use of intrapleural fibrinolytics in the management of postpneumonic empyema. A prospective study. Eur J Cardiothorac Surg. 28(4):599-603, 2005
Tsai TH et al: Community-acquired thoracic empyema in older people. J Am Geriatr Soc. 53(7):1203-9, 2005
Evans AL et al: Radiology in pleural disease: state of the art. Respirology. 9(3):300-12, 2004
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Definitions
Pleural space infection; abscess
Typically infected parapneumonic pleural effusion
May result from hematogenous seeding of bacteria
Rare but dangerous complication of chest surgery, trauma, mediastinitis, esophageal perforation
Complication of other disease process, e.g., sub-diaphragmatic abscess
Empyema necessitatis
Empyema that drains spontaneously to chest wall; pleurocutaneous fistula
Large or rapidly expanding pleural infection with lung compression and mediastinal shift
Rarely complicated by cardiac arrest
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Garvia V et al: Empyema 2020
Godfrey MS et al: Medical and surgical management of empyema. Semin Respir Crit Care Med. 40(3):361-74, 2019
Shaw JA et al: Pleural tuberculosis: a concise clinical review. Clin Respir J. 12(5):1779-86, 2018
Santamarina MG et al: Multidetector CT for evaluation of the extrapleural space. Radiographics. 37(5):1352-70, 2017
Shen KR et al: The American Association for Thoracic Surgery consensus guidelines for the management of empyema. J Thorac Cardiovasc Surg. 153(6):e129-46, 2017
Wongwaisayawan S et al: Emergency thoracic US: the essentials. Radiographics. 36(3):640-59, 2016
Helm EJ et al: Imaging of the pleura. J Magn Reson Imaging. 32(6):1275-86, 2010
Kraus GJ: The split pleura sign. Radiology. 243(1):297-8, 2007
Chae EJ et al: Radiographic and CT findings of thoracic complications after pneumonectomy. Radiographics. 26(5):1449-68, 2006
Qureshi NR et al: Imaging of pleural disease. Clin Chest Med. 27(2):193-213, 2006
Wurnig PN et al: Video-assisted thoracic surgery for pleural empyema. Ann Thorac Surg. 81(1):309-13, 2006
Bramley D et al: Tension empyema as a reversible cause for cardiac arrest. Emerg Med J. 22(12):919-20, 2005
Cheng G et al: A retrospective analysis of the management of parapneumonic empyemas in a county teaching facility from 1992 to 2004. Chest. 128(5):3284-90, 2005
Falguera M et al: Etiology and outcome of community-acquired pneumonia in patients with diabetes mellitus. Chest. 128(5):3233-9, 2005
Misthos P et al: Early use of intrapleural fibrinolytics in the management of postpneumonic empyema. A prospective study. Eur J Cardiothorac Surg. 28(4):599-603, 2005
Tsai TH et al: Community-acquired thoracic empyema in older people. J Am Geriatr Soc. 53(7):1203-9, 2005
Evans AL et al: Radiology in pleural disease: state of the art. Respirology. 9(3):300-12, 2004
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