What is Empyema Thoracis?

Empyema thoracis is a very terrible illness. Empyema is actually pus. Thoracis is the chest. So by definition it is pus in the chest. However, empyema thoracis actually is pus in the space between the lungs and the chest wall known as the pleural cavity. Pus accumulates in the pleural space pushing against the lungs. As more and more pus is produced, the pus begins to push against the lungs making more difficult to breathe. The infection usually originates in the lungs and then spreads to the pleural space. A person usually has an underlying disease or infection before they develop empyema thoracis including pneumonia, lung cancer, chest wound, surgery, or bone cancer.

As many of you know, I am a Respiratory Therapist. One of my patients, who has multiple sclerosis also has developed empyema thoracis. The Pulmonologist put in a chest tube. The infection was so thick, that they also put in steptokinase to try to thin out the pus to drain it.

Although empyema thoracis signs and symptoms may vary, the most common ones are the following: Fever, coughing, weight loss, shortness of breath, chest pain, and fatigue. As it becomes a larger infection, the work of breathing increases and a person will need to be hospitalized to get help with their breathing and to have this infection drained. In more serious cases, surgery is required and a lobectomy may be necessary (partial lung removal).

When empyema thoracis becomes severe, the pus abscess can spread to other parts of the body and infect other organs. This can cause multi organ failure. Empyema thoracis is very important to get treated as soon as possible. As mentioned above treatments include chest tube, thorocentesis, surgery. Additionally, a very rigorous regime of antibiotics will be given.


Anytime the lungs are effected by an illness, it can become life threatening. It is very important to seek treatment early.