Empyema classification: Difference between revisions

	Empyema Microchapters
Patient Information
Overview
Classification Subdural empyema Pleural empyema
Differential Diagnosis

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Revision as of 23:20, 2 January 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Classification

Empyema may be classified according to the etiology, anatomical location, and pathological course of the disease as follows:

Primary vs secondary empyema

Primary empyema occurs most commonly iatrogenic empyema without associated pneumonia whereas secondary empyema happens more commonly secondary to pneumonia.

Empyema necessitans

Empyema necessitans is a spontaneous discharge of an empyema that has burrowed through the parietal pleura into the chest wall to form a subcutaneous abscess that may eventually rupture through the skin.

Empyema may be classified according to the stage of the disease as follows:

Exudative

In the exudative stage, the pus accumulates, and initial sterile fluid becomes infected with fluid characteristics of [glucose>60,pH>7.2,LDH<500]

Fibrinopurulent

During this stage, bacterial multiplies with increase in polymorphs and fibrin deposition on both pleural surfaces with fluid characteristics of [ glucose<40,pH <7.2,LDH>1000]

Organizing

During this stage is characterized by loculations, inelastic membranous peel, and lung entrapment as a result of scarring of the pleural space.

References

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 ==Classification==
-There are 3 stages: exudative, fibrinopurulent and organizing. In the exudative stage, the pus accumulates. This is followed by the fibrinopurulent stage in which there is loculation of the pleural fluid (the creation of grapelike pus pockets). In the final organizing stage, scarring of the pleural space may lead to lung entrapment.
+Empyema may be classified according to the etiology, anatomical location, and pathological course of the disease as follows:
+===Primary vs secondary empyema===
+Primary empyema occurs most commonly iatrogenic empyema without associated pneumonia whereas secondary empyema happens more commonly secondary to pneumonia.
+===Empyema necessitans===
+Empyema necessitans is a spontaneous  discharge of an empyema that has burrowed through the parietal pleura into the chest wall to form a subcutaneous abscess that may eventually rupture through the skin.
+Empyema may be classified according to the stage of the disease as follows:
+*Exudative
+In the exudative stage, the pus accumulates, and initial sterile fluid becomes infected with fluid characteristics of [glucose>60,pH>7.2,LDH<500]
+*Fibrinopurulent
+During this stage, bacterial  multiplies with increase in polymorphs and fibrin deposition on both pleural surfaces with fluid characteristics of [ glucose<40,pH <7.2,LDH>1000]
+*Organizing
+During this stage is characterized by loculations, inelastic membranous peel, and lung entrapment as a result of scarring of the pleural space.
 ==References==