Empyema

Changed by Yuranga Weerakkody, 11 Sep 2015

Updates to Synonym Attributes

Updates to Article Attributes

Body was changed:

Empyemas are purulent inflammatory collections within a body cavity. They are similar to abscesses, which arise within parenchymal tissue rather than occupying a pre-existing anatomical space.

Terminology

Colloquially, the term empyema is used to refer to thoracic empyemasbut there are various different types of empyema which are described by the organ affected:

Pathology

Empyemas are predominantly caused by bacterial infection of fluid within a pre-existing anatomical space. Once significant bacterial translocation has occurred there is significant deposition of fibrin and a reactive inflammatory response which results in the accumulation of pyogenic and fibrous material within the cavity.

The pathogenesis of an empyema usually requires a small stagnant fluid collection which in the case of the gallbladder requires a degree of biliary tract obstruction. 

Treatment and prognosis

Like abscesses, as the vascular supply an empyema is poor antimicrobial treatment on its own is usually insufficient to treat the underlying infection and drainage of the collection is usually required. This is often done percutaneously with ultrasound guidance although open surgical drainage can be necessary in complex cases. 

Differential diagnosis

See also

  • -<p><strong>Empyemas </strong>are purulent inflammatory collections within a body cavity. They are similar to <a href="/articles/abscess">abscesses</a>, which arise within parenchymal tissue rather than occupying a pre-existing anatomical space.</p><h4>Terminology</h4><p>Colloquially, the term empyema is used to refer to <a title="Thoracic empyemas" href="/articles/thoracic-empyema-1">thoracic empyemas</a><strong> </strong>but there are various different types of empyema which are described by the organ affected:</p><ul>
  • -<li><a title="Gallbladder empyema" href="/articles/gallbladder-empyema">gallbladder empyema</a></li>
  • -<li><a title="Subdural empyema" href="/articles/subdural-empyema">subdural empyema</a></li>
  • -<li><a title="Thoracic empyema" href="/articles/thoracic-empyema-1">thoracic empyema</a></li>
  • -<li>joint empyema (of any synovial joint)</li>
  • -<li>empyema cystitis (urinary bladder)</li>
  • +<p><strong>Empyemas </strong>are purulent inflammatory collections within a body cavity. They are similar to <a href="/articles/abscess">abscesses</a>, which arise within parenchymal tissue rather than occupying a pre-existing anatomical space.</p><h4>Terminology</h4><p>Colloquially, the term empyema is used to refer to <a href="/articles/thoracic-empyema-1">thoracic empyemas</a><strong> </strong>but there are various different types of empyema which are described by the organ affected:</p><ul>
  • +<li><a href="/articles/gallbladder-empyema">gallbladder empyema</a></li>
  • +<li><a href="/articles/subdural-empyema">subdural empyema</a></li>
  • +<li><a href="/articles/thoracic-empyema-1">thoracic empyema</a></li>
  • +<li>
  • +<a title="joint empyema" href="/articles/joint-empyema">joint empyema</a> (of any synovial joint)</li>
  • +<li>
  • +<a title="empyema cystitis" href="/articles/empyema-cystitis">empyema cystitis</a> (urinary bladder)</li>
  • -<li>loculated <a title="Pleural effusions" href="/articles/pleural-effusion">pleural effusions</a>
  • +<li>loculated <a href="/articles/pleural-effusion">pleural effusions</a>

References changed:

  • 1. Oheim R, Gille J, Schoop R et-al. Surgical therapy of extensive knee joint empyema: mid-term results after two-stage versus one-stage procedures. Knee Surg Sports Traumatol Arthrosc. 2014;22 (12): 3150-6. <a href="http://dx.doi.org/10.1007/s00167-013-2754-y">doi:10.1007/s00167-013-2754-y</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/24217715">Pubmed citation</a><span class="auto"></span>
  • 2. Stark DD, Federle MP, Goodman PC et-al. Differentiating lung abscess and empyema: radiography and computed tomography. AJR Am J Roentgenol. 1983;141 (1): 163-7. <a href="http://dx.doi.org/10.2214/ajr.141.1.163">doi:10.2214/ajr.141.1.163</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/6602513">Pubmed citation</a><span class="auto"></span>

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