All About Empyema: Identifying Symptoms, Understanding Causes, and Discussing Treatments
In the space between the lungs and the chest wall, a condition known as empyema can develop. This article provides an overview of complicated empyema, a severe form of the condition characterised by the accumulation of pus in the pleural space.
Complicated empyema is often the result of untreated or severe pleural infections, with bacterial pneumonia being the most common cause. Other contributing factors include lung abscesses, chest trauma or surgery, tuberculosis, and certain malignancies.
Symptoms of complicated empyema can include persistent fever, chest pain (usually pleuritic, meaning it worsens with deep breaths), cough, shortness of breath, malaise, and signs of systemic infection. In more advanced cases, signs of sepsis or respiratory distress may develop.
Diagnosis of complicated empyema typically involves imaging tests such as chest X-rays, ultrasounds, or CT scans, which reveal pleural fluid collections. Thoracentesis, a procedure where a sample of pleural fluid is removed for analysis, can confirm the presence of empyema and identify the causative bacteria.
Treatment for complicated empyema requires a multidisciplinary approach. Antibiotic therapy is crucial, with empirical intravenous antibiotics started promptly and tailored according to the likelihood of community- or hospital-acquired infection. Drainage procedures, such as thoracentesis or the placement of chest tubes, are also essential to remove pus from the pleural space.
In some cases, surgery may be necessary. This could involve video-assisted thoracoscopic surgery (VATS) for decortication or open thoracotomy, depending on the severity of the condition. VATS is less invasive than an open thoracotomy.
A study found that people who had experienced empyema symptoms for less than two weeks had better results from surgery than those who had experienced the symptoms for longer. In some cases, fibrinolytic therapy may be recommended to aid in the drainage of pleural fluid, in combination with a tube thoracostomy.
Early diagnosis and treatment are vital to avoid complications such as lung entrapment and sepsis. If fibrosis, a possible complication of empyema, causes difficulty breathing that affects a person's quality of life for more than three months, decortication surgery may help.
In conclusion, complicated empyema is a serious lung condition that requires prompt and effective treatment. A combination of antibiotics, drainage, and potentially surgery can help manage the condition. Early recognition and treatment are key to avoiding complications and ensuring the best possible outcomes.
Self-care and medical-condition awareness are essential for prompt empyema detection. Complicated empyema, characterized by pus accumulation in the pleural space, can have severe consequences, and its symptoms may include persistent fever, chest pain, cough, shortness of breath, malaise, and signs of systemic infection.
Medicine with a multidisciplinary approach is vital for treating complicated empyema, such as antibiotic therapy and drainage procedures. These may involve intravenous antibiotics, thoracentesis, chest tubes, and, in some cases, surgery like VATS or open thoracotomy.
Empirical antibiotics should be started promptly, with therapy tailored according to the likelihood of community- or hospital-acquired infection. Furthermore, therapies and treatments like fibrinolytic therapy may help with the drainage of pleural fluid in combination with tube thoracostomy.
Healthcare professionals should emphasize health-and-wellness education concerning empyema, especially the importance of early diagnosis and treatment to avoid complications like lung entrapment, sepsis, fibrosis, and difficulty breathing affecting a person's quality of life for more than three months. Decortication surgery could potentially alleviate such complications when necessary.
