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Empyema

MedGen UID:
8597
•Concept ID:
C0014009
•
Disease or Syndrome
Synonyms: collection of pus; empyema
SNOMED CT: Empyema (66696003); Empyema (312682007)
 
Monarch Initiative: MONDO:0005242

Definition

An accumulation of pus in the pleural space. [from NCI]

Professional guidelines

PubMed

Medical and Surgical Management of Empyema.
Godfrey MS, Bramley KT, Detterbeck F
Semin Respir Crit Care Med 2019 Jun;40(3):361-374. Epub 2019 Sep 16 doi: 10.1055/s-0039-1694699. PMID: 31525811
Pleural Effusion in Adults-Etiology, Diagnosis, and Treatment.
Jany B, Welte T
Dtsch Arztebl Int 2019 May 24;116(21):377-386. doi: 10.3238/arztebl.2019.0377. PMID: 31315808Free PMC Article
The American Association for Thoracic Surgery consensus guidelines for the management of empyema.
Shen KR, Bribriesco A, Crabtree T, Denlinger C, Eby J, Eiken P, Jones DR, Keshavjee S, Maldonado F, Paul S, Kozower B
J Thorac Cardiovasc Surg 2017 Jun;153(6):e129-e146. Epub 2017 Feb 4 doi: 10.1016/j.jtcvs.2017.01.030. PMID: 28274565

Recent clinical studies

Etiology

Parapneumonic Effusion and Empyema.
Addala DN, Bedawi EO, Rahman NM
Clin Chest Med 2021 Dec;42(4):637-647. doi: 10.1016/j.ccm.2021.08.001. PMID: 34774171
Hyperbaric oxygen for intracranial abscess.
Tomoye EO, Moon RE
Undersea Hyperb Med 2021 First Quarter;48(1):97-102. doi: 10.22462/01.03.2021.12. PMID: 33648039
Use of fibrinolytics and deoxyribonuclease in adult patients with pleural empyema: a consensus statement.
Chaddha U, Agrawal A, Feller-Kopman D, Kaul V, Shojaee S, Maldonado F, Ferguson MK, Blyth KG, Grosu HB, Corcoran JP, Sachdeva A, West A, Bedawi EO, Majid A, Mehta RM, Folch E, Liberman M, Wahidi MM, Gangadharan SP, Roberts ME, DeCamp MM, Rahman NM
Lancet Respir Med 2021 Sep;9(9):1050-1064. Epub 2021 Feb 2 doi: 10.1016/S2213-2600(20)30533-6. PMID: 33545086
Thoracic Surgery in the Pregnant Patient.
Whang B
Thorac Surg Clin 2018 Feb;28(1):1-7. Epub 2017 Oct 18 doi: 10.1016/j.thorsurg.2017.08.002. PMID: 29150031
Pyocystis: a systematic review.
Kamel MH, Gardner R, Tourchi A, Tart K, Raheem O, Houston B, Bissada N, Davis R
Int Urol Nephrol 2017 Jun;49(6):917-926. Epub 2017 Mar 7 doi: 10.1007/s11255-017-1562-6. PMID: 28265966

Diagnosis

Parapneumonic Effusion and Empyema.
Addala DN, Bedawi EO, Rahman NM
Clin Chest Med 2021 Dec;42(4):637-647. doi: 10.1016/j.ccm.2021.08.001. PMID: 34774171
Pleural Disease.
Feller-Kopman D, Light R
N Engl J Med 2018 Feb 22;378(8):740-751. doi: 10.1056/NEJMra1403503. PMID: 29466146
Hepatic hydrothorax.
Norvell JP, Spivey JR
Clin Liver Dis 2014 May;18(2):439-49. Epub 2014 Feb 25 doi: 10.1016/j.cld.2014.01.005. PMID: 24679505
Intracranial dural empyema.
Rich PM, Deasy NP, Jarosz JM
Br J Radiol 2000 Dec;73(876):1329-36. doi: 10.1259/bjr.73.876.11205681. PMID: 11205681
Subdural empyema.
Brennan MR
Am Fam Physician 1995 Jan;51(1):157-62. PMID: 7810468

Therapy

Early Video-assisted Thoracoscopic Surgery or Intrapleural Enzyme Therapy in Pleural Infection: A Feasibility Randomized Controlled Trial. The Third Multicenter Intrapleural Sepsis Trial-MIST-3.
Bedawi EO, Stavroulias D, Hedley E, Blyth KG, Kirk A, De Fonseka D, Edwards JG, Internullo E, Corcoran JP, Marchbank A, Panchal R, Caruana E, Kadwani O, Okiror L, Saba T, Purohit M, Mercer RM, Taberham R, Kanellakis N, Condliffe AM, Lewis LG, Addala DN, Asciak R, Banka R, George V, Hassan M, McCracken D, Sundaralingam A, Wrightson JM, Dobson M, West A, Barnes G, Harvey J, Slade M, Chester-Jones M, Dutton S, Miller RF, Maskell NA, Belcher E, Rahman NM
Am J Respir Crit Care Med 2023 Dec 15;208(12):1305-1315. doi: 10.1164/rccm.202305-0854OC. PMID: 37820359Free PMC Article
Parapneumonic Effusion and Empyema.
Addala DN, Bedawi EO, Rahman NM
Clin Chest Med 2021 Dec;42(4):637-647. doi: 10.1016/j.ccm.2021.08.001. PMID: 34774171
Use of fibrinolytics and deoxyribonuclease in adult patients with pleural empyema: a consensus statement.
Chaddha U, Agrawal A, Feller-Kopman D, Kaul V, Shojaee S, Maldonado F, Ferguson MK, Blyth KG, Grosu HB, Corcoran JP, Sachdeva A, West A, Bedawi EO, Majid A, Mehta RM, Folch E, Liberman M, Wahidi MM, Gangadharan SP, Roberts ME, DeCamp MM, Rahman NM
Lancet Respir Med 2021 Sep;9(9):1050-1064. Epub 2021 Feb 2 doi: 10.1016/S2213-2600(20)30533-6. PMID: 33545086
Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial.
Suzuki K, Saji H, Aokage K, Watanabe SI, Okada M, Mizusawa J, Nakajima R, Tsuboi M, Nakamura S, Nakamura K, Mitsudomi T, Asamura H; West Japan Oncology Group; Japan Clinical Oncology Group
J Thorac Cardiovasc Surg 2019 Sep;158(3):895-907. Epub 2019 Apr 9 doi: 10.1016/j.jtcvs.2019.03.090. PMID: 31078312
Surgical versus non-surgical management for pleural empyema.
Redden MD, Chin TY, van Driel ML
Cochrane Database Syst Rev 2017 Mar 17;3(3):CD010651. doi: 10.1002/14651858.CD010651.pub2. PMID: 28304084Free PMC Article

Prognosis

Increase in invasive group A streptococcal infection notifications, England, 2022.
Guy R, Henderson KL, Coelho J, Hughes H, Mason EL, Gerver SM, Demirjian A, Watson C, Sharp A, Brown CS, Lamagni T
Euro Surveill 2023 Jan;28(1) doi: 10.2807/1560-7917.ES.2023.28.1.2200942. PMID: 36695450Free PMC Article
Ramucirumab plus erlotinib in patients with untreated, EGFR-mutated, advanced non-small-cell lung cancer (RELAY): a randomised, double-blind, placebo-controlled, phase 3 trial.
Nakagawa K, Garon EB, Seto T, Nishio M, Ponce Aix S, Paz-Ares L, Chiu CH, Park K, Novello S, Nadal E, Imamura F, Yoh K, Shih JY, Au KH, Moro-Sibilot D, Enatsu S, Zimmermann A, Frimodt-Moller B, Visseren-Grul C, Reck M; RELAY Study Investigators
Lancet Oncol 2019 Dec;20(12):1655-1669. Epub 2019 Oct 4 doi: 10.1016/S1470-2045(19)30634-5. PMID: 31591063
Spontaneous bacterial empyema.
Tu CY, Chen CH
Curr Opin Pulm Med 2012 Jul;18(4):355-8. doi: 10.1097/MCP.0b013e328352b50f. PMID: 22450302
Pleural tuberculosis.
Chakrabarti B, Davies PD
Monaldi Arch Chest Dis 2006 Mar;65(1):26-33. doi: 10.4081/monaldi.2006.582. PMID: 16700190
Hepatic hydrothorax.
Xiol X, Guardiola J
Curr Opin Pulm Med 1998 Jul;4(4):239-42. doi: 10.1097/00063198-199807000-00011. PMID: 10813241

Clinical prediction guides

Conservative and Surgical Modalities in the Management of Pediatric Parapneumonic Effusion and Empyema: A Living Systematic Review and Network Meta-Analysis.
Fernandez Elviro C, Longcroft-Harris B, Allin E, Leache L, Woo K, Bone JN, Pawliuk C, Tarabishi J, Carwana M, Wright M, Nama N; InsightScope Team
Chest 2023 Nov;164(5):1125-1138. Epub 2023 Jun 17 doi: 10.1016/j.chest.2023.06.010. PMID: 37463660
Hepatic Hydrothorax.
Lv Y, Han G, Fan D
Ann Hepatol 2018 January-February;17(1):33-46. doi: 10.5604/01.3001.0010.7533. PMID: 29311408
Surgical intervention for thoracic infections.
Raymond D
Surg Clin North Am 2014 Dec;94(6):1283-303. Epub 2014 Sep 29 doi: 10.1016/j.suc.2014.08.004. PMID: 25440124
Spontaneous bacterial empyema.
Tu CY, Chen CH
Curr Opin Pulm Med 2012 Jul;18(4):355-8. doi: 10.1097/MCP.0b013e328352b50f. PMID: 22450302
Brain abscess and subdural empyema.
Levy RM
Curr Opin Neurol 1994 Jun;7(3):223-8. doi: 10.1097/00019052-199406000-00008. PMID: 7915942

Recent systematic reviews

Systematic review of ceftaroline fosamil in the management of patients with methicillin-resistant Staphylococcus aureus pneumonia.
Torres A, Kuraieva A, Stone GG, Cillóniz C
Eur Respir Rev 2023 Dec 31;32(170) Epub 2023 Oct 18 doi: 10.1183/16000617.0117-2023. PMID: 37852658Free PMC Article
Comparison of Acetaminophen (Paracetamol) With Ibuprofen for Treatment of Fever or Pain in Children Younger Than 2 Years: A Systematic Review and Meta-analysis.
Tan E, Braithwaite I, McKinlay CJD, Dalziel SR
JAMA Netw Open 2020 Oct 1;3(10):e2022398. doi: 10.1001/jamanetworkopen.2020.22398. PMID: 33125495Free PMC Article
Surgical versus non-surgical management for pleural empyema.
Redden MD, Chin TY, van Driel ML
Cochrane Database Syst Rev 2017 Mar 17;3(3):CD010651. doi: 10.1002/14651858.CD010651.pub2. PMID: 28304084Free PMC Article
Subtotal cholecystectomy for "difficult gallbladders": systematic review and meta-analysis.
Elshaer M, Gravante G, Thomas K, Sorge R, Al-Hamali S, Ebdewi H
JAMA Surg 2015 Feb;150(2):159-68. doi: 10.1001/jamasurg.2014.1219. PMID: 25548894
Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis.
Brouwer MC, Coutinho JM, van de Beek D
Neurology 2014 Mar 4;82(9):806-13. Epub 2014 Jan 29 doi: 10.1212/WNL.0000000000000172. PMID: 24477107

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