Pathology of the Pleura and Mediastinum

2018 Edition
| Editors: Timothy Craig Allen, Saul Suster

Empyema, Pleural

  • Timothy Craig AllenEmail author
  • Riyam T. Zreik
Reference work entry


Complicated parapneumonic effusion; Empyema thoracis; Purulent pleural effusion; Purulent pleuritis; Pyothorax


Pleural empyema is the accumulation of purulent exudate, also known as pus, within the pleural space or a pleural fluid sample with a positive Gram stain and/or culture. Infection of the pleural space has long been recognized as a serious complication of pneumonia in medical literature. Hippocrates understood the clinical significance of empyema thoracis as a major contributor to morbidity and mortality, and around 500 BC, he first described the diagnosis, clinical features, and treatment of empyema using an open thoracic drainage technique. The mortality rate of empyema remained significantly high even with open thoracic drainage. The mortality rate was reduced significantly following the use of closed tube drainage which became popular during the influenza pandemic of 1917–1919. Despite improvements in imaging, antibiotics, and the use of sterile...

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References and Further Reading

  1. Bhatnagar, R., & Maskell, N. (2013). Treatment of complicated pleural effusions in 2013. Clinics in Chest Medicine, 34(1), 47–62. Scholar
  2. Colice, G. L., et al. (2000). Medical and surgical treatment of parapneumonic effusions: An evidence-based guideline. Chest, 118(4), 1158–1171.CrossRefPubMedGoogle Scholar
  3. Desai, H., & Agrawal, A. (2012). Pulmonary emergencies: pneumonia, acute respiratory distress syndrome, lung abscess, and empyema. Medical Clinics of North America, 96(6), 1127–1148. Scholar
  4. Islam, S., et al. (2012). The diagnosis and management of empyema in children: A comprehensive review from the APSA outcomes and Clinical Trials Committee. Journal of Pediatric Surgery, 47(11), 2101–2110. Scholar
  5. Light, R. W. (2013). The Light criteria: The beginning and why they are useful 40 years later. Clinics in Chest Medicine, 34, 21–26. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PathologyThe University of Mississippi Medical School, The University of Mississippi Medical CenterJacksonUSA
  2. 2.Department of PathologyScott and White Healthcare and Texas A&M Health Science Center College of MedicineTempleUSA