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What is empyema?

Empyema is also called pyothorax or purulent pleuritis. It’s a condition in which pus gathers in the area between the lungs and the inner surface of the chest wall. This area is known as the pleural space. Pus is a fluid that’s filled with immune cells, dead cells, and bacteria. Pus in the pleural space can’t be coughed out. Instead, it needs to be drained by a needle or surgery.
Empyema usually develops after pneumonia, which is an infection of the lung tissue.

Conditions that put you at risk

The biggest risk factor for empyema is having pneumonia. Empyema occurs most frequently in children and older adults. However, it’s fairly uncommon. In one study, it occurred in less than 1 percent of children with pneumonia.
Having the following conditions can also increase your chances of empyema after pneumonia:

  • bronchiectasis
  • chronic obstructive pulmonary disease (COPD)
  • rheumatoid arthritis
  • alcoholism
  • diabetes
  • a weakened immune system
  • surgery or recent trauma
  • lung abscess



  • Simple empyema
  • Simple empyema occurs in the early stages of the illness. A person has this type if the pus is free-flowing. The symptoms of simple empyema include:

  • Complex empyema
  • Complex empyema occurs in the later stage of the illness. In complex empyema, the inflammation is more severe. Scar tissue may form and divide the chest cavity into smaller cavities. This is called loculation, and it’s more difficult to treat.