Empyema

A Empyema is a purulent accumulation of fluid in a natural cavity of the body. The lungs are particularly often affected. In most cases, empyema can be treated well; however, the disease can be life-threatening, especially in the lungs.

What is an empyema?

Empyema can manifest itself through various symptoms. Typical for the disease are a sore throat, cough and sputum. The secretions are mostly brownish-green and have an unpleasant odor.
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Doctors understand the term empyema to be an accumulation of purulent fluid in a body cavity. The name means something like "pus forming" in Greek. Usually empyema develops as a result of tissue inflammation, which then leads to the typical formation of fluid.

In many cases, the lungs are affected, or more precisely the cavity around the lungs. This condition is also known as chest or pleural empyema and is called empyema thoracis in specialist circles. In rare cases, the gall bladder or pelvic cavity can also be affected by the accumulation of fluid. An empyema should always be treated medically, as it can lead to the death of the patient without rapid and appropriate therapy.

causes

A bacterial infection is responsible for empyema. In the lungs, the bacterial strains Haemophilus influenzae, which causes diseases such as bronchitis or pneumonia (pneumonia), Streptococcus pneumoniae, which causes pneumonia and meningitis (meningitis) and Staphylococcus aureus, which causes pneumonia and sepsis, but also furuncle, are particularly common in the lungs caused.

The latter is the cause of fluid retention in nearly 90% of all cases affecting babies and toddlers. If the empyema is in the pelvis, the bacterium Pseudomonas aeruginosa is usually responsible. The bacterium Klebsiella pneumoniae is also not infrequently found in older or chronically ill patients.

The pathogens attack the tissue that covers the lungs, for example. As a protective reaction, the body rejects dead cells. At the same time, pus and fluids are formed which, together with the dead cells, fill the body cavities and lead to empyema.

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Symptoms, ailments & signs

Empyema can manifest itself through various symptoms. Typical for the disease are a sore throat, cough and sputum. The secretions are mostly brownish-green and have an unpleasant odor. They occur mainly in the morning and cause the characteristic rattling or piercing breath noises. Usually there is also shortness of breath and fatigue.

In the further course, the physical and mental performance decreases, the affected person is usually no longer able to cope with everyday tasks. Swallowing the secretions can cause abdominal pain, nausea, and vomiting. Diarrhea cannot be ruled out either. This is usually accompanied by bad breath. Many of those affected suffer from a fever, which manifests itself as circulatory problems, sweating and an increasing feeling of illness.

If empyema is left untreated, the infection can spread to other organs. If it spreads to the heart, it can lead to cardiovascular complaints, heart failure and other serious symptoms and complications. If the brain is affected, it can lead to encephalitis or meningitis. In general, spreading the infection is life-threatening and causes general symptoms such as high fever and coma. In extreme cases, the patient dies.

Diagnosis & course

The attending physician can detect pulmonary empyema by listening to the lungs and tapping the chest and back, among other things. If a patient visits the doctor with symptoms such as shortness of breath, cough, chest pain, fever and fatigue, this also indicates fluid retention.

Bad breath and brownish-green sputum can be further clues. An x-ray and an ultrasound examination make the empyema clearly visible. The condition caused by an infection should always be treated medically, otherwise the infection can spread to the heart or brain. These cases lead to a high fever, bloody sputum and eventually to a coma and death of the patient.

When should you go to the doctor?

If there are breathing problems, this is considered worrying. A doctor's visit is necessary if the symptoms persist for a long time or if they increase in intensity. If you feel short of breath or stop breathing, you should consult a doctor. There is a continuous undersupply of the organism, which can end in a life-threatening condition. A doctor is needed in the event of sleep disorders, concentration problems or disturbances in attention.

Palpitations, high blood pressure and problems with the heart rhythm should be examined and treated by a doctor. Without medical treatment, acute conditions can occur that can lead to lifelong impairments. A doctor is needed if you have a fever or persistent tiredness despite getting enough sleep. Chest or abdominal pain needs to be clarified and treated. If the sensation of pain increases, you should see a doctor as soon as possible.

Before taking any pain reliever medication, it is advisable to consult a doctor to clarify possible side effects and risks. Consult a doctor if the cough persists, breath odors or sputum recurs. A doctor should be consulted in the event of strange breathing noises or the inability to inhale deeply. If a bloody sputum occurs when coughing, an emergency doctor should be called as the patient is in critical health.

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Treatment & Therapy

If empyema has been clearly diagnosed, the attending physician must act promptly and initiate therapy. Usually this consists of a combination of medication and surgery. During the operation, the accumulated fluid can be removed, which significantly relieves the pressure and makes breathing easier in the case of pulmonary empyema.

In addition, the organs gain more space in the body. If the infection is at an early stage, the fluid can be removed using a method called thoracentesis. This is a hollow needle that is inserted into the chest cavity. If the empyema is more advanced, the surgeon must open the chest and drain the fluid through a tube. If the tissue is already very badly affected, it must also be surgically removed.

The lungs can then develop better again and fill the chest as usual. In addition to surgery, the bacterial infection must be treated. Antibiotics, especially penicillin, are administered for this purpose.

These should be given for at least two weeks to ensure that all bacteria have been killed. The medication is usually given intravenously, as this enables them to work faster and more effectively. The earlier the empyema is recognized, the more effective the drug treatment is.

Outlook & forecast

It is very difficult to make an exact outlook and prognosis, as medical treatment can have a positive effect on the course of the disease. In most cases, such empyema develops in connection with bursitis. Such an inflammation usually subsides within a few days. The production of pus decreases, so that an uncomplicated healing process can be expected. The prospect of a complete cure thus looks very good.

If, however, the pus formation does not recede, but increases, then the course of the disease can be expected to be more difficult. The prolonged production of pus can cause bacteria to form, which can cause severe inflammation.

If such a clinical picture remains without any treatment, then the course of the disease can be expected to be significantly more difficult. Under certain circumstances, an abscess can form. If you do not visit the doctor in such a case, then in the worst case scenario blood poisoning can occur.

You can find your medication here

➔ Medicines for lung and bronchial problems

prevention

Since empyema is a bacterial infection, prevention in the strict sense is not possible. A healthy lifestyle strengthens the immune system and can improve the general condition of the individual. However, this does not rule out the possibility of empyema nonetheless. If the first symptoms occur, those affected and family members should consult a doctor as soon as possible.

If the fluid build-up is detected at an early stage, it may be possible to treat it with medication alone and to prevent the condition from worsening. If symptoms such as shortness of breath, fever or abnormal sputum appear, it is advisable to see a doctor in case of doubt and to clarify the causes of the symptoms.

Aftercare

In the case of empyema, early treatment is very important so that there are no further complications or, in the worst case, death of the person affected. The earlier the disease is recognized, the better the further course of the disease is usually. Therefore, the early detection of empyema is in the foreground.

As a rule, however, the measures or options for follow-up care are very limited or not really necessary. The treatment itself takes place with the help of a surgical procedure. After this procedure, the person affected should under no circumstances exert themselves or be active. Stressful or sporting activities should be avoided in any case, so as not to unnecessarily burden the body.

Furthermore, it is often advisable to take antibiotics after the procedure to prevent infections. Antibiotics should not be taken together with alcohol, otherwise their effect will be significantly reduced. If in doubt or if anything is unclear, a doctor can always be contacted. In most cases, empyema will not reduce life expectancy either if treatment is started early. The lungs should not be unnecessarily stressed after the procedure, so smoking should also be avoided.

You can do that yourself

Empyema is a disorder that has to be taken seriously and should by no means be treated independently with home remedies or over-the-counter drugs. The best form of self-help is to consult a doctor promptly and strictly follow his instructions. Failure to do so could result in serious complications such as blood poisoning. Lung empyema can even be fatal.

If empyema is discovered early, it can usually be treated with antibiotics before complications set in. The antibiotics must be taken as prescribed by the doctor. Under no circumstances should antibiotic treatment be interrupted or terminated prematurely.

This also applies if there are side effects. A patient may treat these side effects with mild home remedies after consulting a doctor. Antibiotics not only kill pathogens, but also beneficial intestinal bacteria, which often leads to severe diarrhea. Probiotic foods, especially yogurt, can help the intestines recover.

Women often develop yeast infections of the vagina during or shortly after treatment with antibiotics. This side effect can be prevented by using lactic acid suppositories, which are available over-the-counter at pharmacies.

A healthy lifestyle supports the body's defenses, which accelerates the healing of the empyema.