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Semin intervent Radiol 2012; 29(03): 226-230
DOI: 10.1055/s-0032-1326933
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Emergent Management of Empyema

Osman Ahmed
1   Department of Radiology, University of Chicago, Chicago, Illinois
,
Steven Zangan
1   Department of Radiology, University of Chicago, Chicago, Illinois
› Author Affiliations
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Publication History

Publication Date:
16 October 2012 (online)

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Abstract

Empyema is a frankly purulent infection of the pleural space most often occurring secondary to parapneumonic effusion. Imaging, specifically contrast-enhanced computed tomography, plays a critical role in diagnosis with a “split pleura” sign being highly suggestive in the appropriate clinical setting. Diagnostic thoracentesis with culture and Gram stain further guides appropriate antibiotic therapy. Therapeutic drainage with small-bore tube thoracostomy has been shown to be a safe and effective treatment of early stage empyema. Augmentation of tube placement with intrapleural fibrinolytics and mucolytics facilitates catheter drainage by degrading loculations and decreasing fluid viscosity, respectively.

Keywords

empyema - chest tube - fibrinolytics - mucolytics - split pleura sign
 

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