Empyema - Symptoms, diagnosis and treatment | BMJ Best Practice Empyema is defined as the presence of pus in the pleural space Risk factors include pneumonia, iatrogenic intervention in the pleural space, diabetes, and alcohol abuse In patients with symptoms and signs of infection and a significant pleural effusion, thoracentesis (pleural aspiration) must be performed urgently
Community-acquired pneumonia in children - BMJ Best Practice Empyema is an advanced stage of parapneumonic effusion, with a complicated outcome In empyema, effusions are initially exudative; without treatment they become fibro-purulent, loculated, and infected Ongoing fibroblastic growth causes a thick peel to form over the visceral pleura, preventing lung expansion
Community-acquired pneumonia in children - BMJ Best Practice Chest x-ray and blood cultures are only indicated for children who are hospitalised for severe CAP or complications of CAP (e g , pleural effusion, empyema, necrotising pneumonia, lung abscess) Empirical antibiotic therapy is indicated for all children who are clinically diagnosed with CAP
Assessment of clubbing - BMJ Best Practice An important nail sign of systemic disease linked with underlying pulmonary, cardiovascular, neoplastic, infectious, hepatobiliary, mediastinal, endocrine, and gastrointestinal disorders
Acute cholecystitis - Management recommendations - BMJ Best Practice Gallbladder empyema can result when cholecystitis is left to progress with concurrent bile stasis and cystic duct obstruction It is a surgical emergency Gallbladder empyema is the most severe form of acute cholecystitis
Differential diagnosis of symptoms - BMJ Best Practice Haemoptysis is the coughing of blood from a source below the glottis It can range from a small amount of blood-streaked sputum to massive bleeding with life-threatening consequences due to airway obstruction, hypoxaemia, and haemodynamic instability