The goal of treatment is to cure the infection and remove the collection of pus from the lung. Empyema should be drained immediately with chest tube insertion. Appropriate Antibiotics should be started immediately, empiric to start with followed by specific drug based on culture. Streptokinase is useful to break up adhesions if there are loculations. Some patients not responding to this regimen may require thoracotomy to lyse adhesions. This can be accomplished by thoracoscope. Some would require decortication, if a thick pyemic peel has formed and prevent lung expansion. A surgeon may need to perform a decortication (peeling away the lining of the lung) if the lung does not expand properly.
More information on empyema
What is empyema? - Empyema is the presence of gross pus in the pleural cavity; it consists of an effusion containing polymorphonuclear leukocytes and fibrin. What causes empyema? - Empyema is caused by an infection that often spreads from the lungs following pneumonia. A subdural empyema may result from a sinus infection, a severe ear infection. What're the symptoms of empyema? - The signs and symptoms of empyema vary somewhat according to the location of the infection and its severity. How is empyema diagnosed? - The diagnosis of empyema is usually confirmed by analyzing a sample of fluid taken from the pleural cavity. What's the treatment for empyema? - The goal of treatment for empyema is to cure the infection and remove the collection of pus from the lung.
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