Respiratory system >>>> Empyema of the lungs

Empyema of the lungs (empyema of the pleura).

Empyema of the lungs (empyema of the pleura) is a complication of an infectious lesion of the lung tissue (for example, pneumonia), when fluid (effusion) accumulates in the pleural cavity and the purulent process from the lung passes into the pleura. The nature of the fluid differs depending on the stage of the process (exudate, fibrous-purulent contents). The accumulation of pus between the pleural layers often forms purulent pockets, later the pleural tissues are scarred, which can be complicated by clogging of the pleural cavity and lead to the development of pulmonary insufficiency.

Signs of pleural empyema (empyema of the lung) depend on the severity of the purulent process and its extent:

The accumulation of fluid in the pleural cavity reduces the volume of expansion of the lungs during inhalation, which inevitably leads to shortness of breath (first with physical exertion, and then at rest);
Purulent processes are accompanied by general intoxication of the body, which affects the general state of health: weakness, headache, chills, sweating;
There is pain in the chest when inhaling (with deep breathing, the pain symptom increases);
A dry cough develops, aggravating chest pain, in the presence of bronchopleural fistulas, the cough may be accompanied by purulent sputum;
A patient with pleural empyema (lung empyema) takes a forced position - half-sitting with an emphasis on his hands, put behind his back;
A long course of the disease (from one to several months, depending on the acute or chronic form of the course of the disease) provokes a decrease in appetite and a decrease in body weight;
On examination, vesicular breathing is observed from the side of the compressed lung, auscultation gives a short percussion sound.

Hardware diagnosis of the disease (X-ray, ultrasound, computed tomography of the chest area) is confirmed by laboratory examination of purulent contents.

Treatment of empyema of the lungs consists in draining the pleural cavity, washing it with antiseptic agents, proteolytic enzymes. In parallel, antibacterial therapy is prescribed. In difficult cases, thoracotomy is performed - opening the chest for access to the pleural cavity in order to empty the pleural cavity from purulent contents.