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An empyema is a pocket of pus outside the surface of the lung and inside the inner surface of the chest wall. The fluid may build up and put pressure on the lungs. This can make it hard to breath and may cause pain.

The Lungs (cut-away view)
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Empyema is caused by a lung infection that spreads outside of the lung.

It can also happen after some chest procedures, such as thoracentesis.

Risk Factors

Things that may raise the risk of empyema are having:


Symptoms may be:

  • Coughing
  • Problems breathing
  • Fever, chills, and sweating
  • Chest pain
  • Losing weight without trying


You will be asked about your symptoms and health history. A physical exam will be done.

Pictures of the lungs and chest may be taken. This can be done with:

Thoracentesis may be done. A needle will be inserted through the chest wall and fluids will be collected for testing.


Treatment options are:


Antibiotics will be given to treat the infection.


Surgery may be done to drain the empyema. This can be done with:

  • Thoracentesis
  • A chest tube

Diseased tissue and fluids may be removed with surgery. This can be done with video-assisted thoracoscopic surgery or thoracotomy.


Get medical help right away for any symptoms of a lung infection.


American College of Surgeons  https://www.facs.org 

Family Doctor—American Academy of Family Physicians  http://www.familydoctor.org 


Canadian Association of Thoracic Surgeons  http://www.canadianthoracicsurgeons.ca 

Health Canada  https://www.canada.ca 


Empyema. NHS Choices website. Available at: http://www.nhs.uk/conditions/empyema/Pages/Introduction.aspx. Updated November 22, 2018. Accessed November 25, 2019.

Parapneumonic effusion and empyema in adults. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/parapneumonic-effusion-and-empyema-in-adults . Updated June 14, 2017. Accessed November 25, 2019.

Pleural effusion and empyema. Mount Sinai Beth Israel Hospital website. Available at: https://www.mountsinai.org/locations/beth-israel/care/thoracic-surgery. Accessed November 25, 2019.

Yu H. Management of pleural effusion, empyema, and lung abscess. Semin Intervent Radiol. 2011 Mar;28(1):75-86.

Revision Information

  • Reviewer: EBSCO Medical Review Board James P. Cornell, MD
  • Review Date: 09/2019
  • Update Date: 04/24/2020