Pyopneumothorax
Updates to Synonym Attributes
Updates to Synonym Attributes
Updates to Article Attributes
Pyopneumothorax (also known as infected hydropneumothorax or empyemic hydropneumothorax) is a pleural collection of pus and air. It may be thought of a variant of a thoracic empyema with air containing conponents although the aetiology may be different.
Pathology
As with a hydropneumothorax, it may also arise in various situations which include
- thoracocentesis
- thoracic trauma
- bronchopleural fistula
- oesophagopleural fistula
Many causative organisms have been implicated including Mycobacterium tuberculosis, anaerobs, pyogenic and fungal.
Clinical presentation
The patient usually presents with chest pain and fever. Cough and breathing difficulty may be present.
Radiographic features
Plain film
An air fluid level is noted. It may be loculated. Loss of silhouette with the dome of diaphragm may be seen. It may be difficult to differentiate a pyopneumothorax from non-infected hydropneumothorax. Presence of thick pleural lining strongly favorsfavours the former.
Ultrasound
Fine internal echoes in the pleural collection strongly suggests infected fluid in appropriate clinical settings.
CT
It will clearly depict the location of the collection as well as thickening of pleura and underlying disease process (if any).
Treatment
Large collections require intercostal drainage with antibiotics.
Differential diagnosis
- non-infected hydropneumothorax (no pleural thickening)
- peripheral lung abscess
Treatment
Large collections require intercostal drainage with antibiotics.
-<p><strong>Pyopneumothorax </strong>(also known as <strong>infected hydropneumothorax</strong> or <strong>empyemic hydropneumothorax</strong> ) is a pleural collection of pus and air. </p><h4>Pathology</h4><p>As with hydropneumothorax, it may also arise in various situations which include</p><ul>- +<p><strong>Pyopneumothorax </strong>(also known as <strong>infected hydropneumothorax</strong> or <strong>empyemic hydropneumothorax</strong>) is a pleural collection of pus and air. It may be thought of a variant of a <a title="Thoracic empyemas" href="/articles/thoracic-empyema-1">thoracic empyema</a> with air containing conponents although the aetiology may be different.</p><h4>Pathology</h4><p>As with a hydropneumothorax, it may also arise in various situations which include</p><ul>
-</ul><p>Many causative organisms have been implicated including <em>Mycobacterium tuberculosis</em>, anaerobs, pyogenic and fungal.</p><h4>Clinical presentation</h4><p>The patient usually presents with chest pain and fever. Cough and breathing difficulty may be present.</p><h4>Radiographic features</h4><h5>Plain film</h5><p>An air fluid level is noted. It may be loculated. Loss of silhouette with the dome of diaphragm may be seen. It may be difficult to differentiate a pyopneumothorax from non-infected hydropneumothorax. Presence of thick pleural lining strongly favors the former.</p><h5>Ultrasound</h5><p>Fine internal echoes in the pleural collection strongly suggests infected fluid in appropriate clinical settings.</p><h5>CT</h5><p>It will clearly depict the location of the collection as well as thickening of pleura and underlying disease process (if any).</p><h4>Differential diagnosis</h4><ul>- +</ul><p>Many causative organisms have been implicated including <em>Mycobacterium tuberculosis</em>, anaerobs, pyogenic and fungal.</p><h4>Clinical presentation</h4><p>The patient usually presents with chest pain and fever. Cough and breathing difficulty may be present.</p><h4>Radiographic features</h4><h5>Plain film</h5><p>An air fluid level is noted. It may be loculated. Loss of silhouette with the dome of diaphragm may be seen. It may be difficult to differentiate a pyopneumothorax from non-infected hydropneumothorax. Presence of thick pleural lining strongly favours the former.</p><h5>Ultrasound</h5><p>Fine internal echoes in the pleural collection strongly suggests infected fluid in appropriate clinical settings.</p><h5>CT</h5><p>It will clearly depict the location of the collection as well as thickening of pleura and underlying disease process (if any).</p><h4>Treatment</h4><p>Large collections require intercostal drainage with antibiotics.</p><h4>Differential diagnosis</h4><ul>
-</ul><h4>Treatment</h4><p>Large collections require intercostal drainage with antibiotics.</p><p> </p><p> </p>- +</ul><p> </p><p> </p>
References changed:
- 4. Verma SK, Mahajan V. Complete radiological clearance in bilateral loculated pyopneumothorax managed conservatively. Lung India. 2009;26 (2): 55-6. <a href="http://dx.doi.org/10.4103/0970-2113.48901">doi:10.4103/0970-2113.48901</a> - <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2860418">Free text at pubmed</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/20440398">Pubmed citation</a><span class="auto"></span>
- 5. Kartaloglu Z, Okutan O, Işitmangil T et-al. Pyo-pneumothorax in patients with active pulmonary tuberculosis: an analysis of 17 cases without intrapleural fibrinolytic treatment. Med Princ Pract. 2006;15 (1): 33-8. <a href="http://dx.doi.org/10.1159/000089383">doi:10.1159/000089383</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/16340225">Pubmed citation</a><span class="auto"></span>
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