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...