Adult health Nursing- Respiratory disorder - Empyema -

1. EMPYEMA
By
Mr. Anandh sam Perera. S. M.Sc (N)

2. DEFINITION
 Empyema is a collection of pus in the cavity
between the lung and the pleura. It consists of
an effusion containing polymorphonuclear
leukocytes and fibrin

3. ETIOLOGY
 Empyema is caused by an infection that spreads
from the lungs and leads to accumulation of pus in
the pleural space.
 The most common organisms that cause empyema
are: streptococcus pneumonmiae, H.influenza & S.
aureus.

4. PHASES/ PATHOPHYSIOLOGY:
 Exudative:
During this phase, the pus accumulates
 Fibrinopurulent:
Exudative is followed by this phase, in which
there is loculation of the pleural cavity (
grapelike pockets of pus)
 Organizing:
There is the potential for lung entrapment by
scarring.

5. CLINICAL MANIFESTATIONS:
 S/S vary according to the location of the infection &
its severity.
 Shortness of breath
 Dry cough
 Fever & chills – 105d F
 Excessive sweating, especially night sweat
 General discomfort, uneasiness or ill feeling
 Unintentional wt. loss
 Chest pain which worsens on deep inhalation
 Decreased breath sounds or a friction rub.

6. DIAGNOSTIC EVALUATION:
 H.C
 P.E – notifications of decrease in breath sounds
or friction rub when listening to the chest with
stethoscope.
 Thoracentesis
 Gram staining and culture of pleural fluid
 CT scan
 Chest X-ray.

7. MANAGEMENT:
 Aim: to cure the infection and also remove the
pus accumulated in the lung
 Antibiotics – eg. Penicillin / vancomycin
 O2 therapy
 Chest Physio
 Bronchodilators
Surgical Mgt:
 1st stage – thoracentesis
 2nd stage – chest tube drainage
 3rd stage - decortication