3. Empyema Thoracis
Pus in pleural space.
End stage of pleural infection from any
cause.
Results from underlying lung (lung
abscess/pneumonia).
Can occur as a complication of any
thoracic complications.
Associated with pus under diaphragm.
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4. Direct injury.
Hematogenous spread, lymphatic spread.
Empyema Thoracis
Mode of transmission
Empyema Thoracis is never primary.
Commonest organism - Staphylococcus Aureus, G(+).
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7. Stages Of Empyema
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1. ACUTE EMPYEMA /EXUDATIVE PHASE
Within 2 weeks (pleurisy).
Invasion of microorganisms into pleural space.
Exudation in pleural space.
Treatment : Antibiotics, Aspiration with wide bore
needle when fluid consistency is thin.
8. Stages Of Empyema
Beyond 2 weeks.
Fibrin deposition on the surface of pleura.
Pus becomes more purulent.
Treatment: Antibiotics, ICD Tube with large tube as
much as possible.
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2. FIBRINOPURULENT PHASE/SUBACUTE
PHASE
9. Stages Of Empyema
2. FIBRINOPURULENT PHASE/SUBACUTE
PHASE
ICD tube : underwater sealed
drainage system in Triangle of
safety.
MEDIAL : Lateral border of P.
Major.
LATERAL : Mid axillary line.
LOWER : Upper border of fifth rib.
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11. ICD Tube
If Empyema is due to
Open type Pneumothorax
( bronchopleural fistula ),
two ICD tubes are
necessary.
One for the drainage of
pus & the another one for
the drainage of air.
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12. Stages Of Empyema
Beyond 6 weeks.
Fibrous septa appear.
Pus - more purulent.
Pleura - calcified.
Lung is encased within the fibrous wall, remains
functionless and immobile (Frozen Chest).
3. ORGANIZING PHASE/CHRONIC EMPYEMA
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13. Stages Of Empyema
D/t fibrosis,
Trachea shift to the affected side.
Diaphragm is pulled upward.
Scoliosis and Rib crowding.
3. ORGANIZING PHASE/CHRONIC EMPYEMA
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20. General : Fever, Dyspnea.
Chest wall deformity & pus discharging sinus
maybe present in chronic case.
Chest wall movement is reduced in affected side.
Clinical Features
Signs
-Inspection
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