Empyema classification: Difference between revisions
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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.<ref name="pmid24326441">{{cite journal| author=Gomes MM, Alves M, Correia JB, Santos L| title=Empyema necessitans: very late complication of pulmonary tuberculosis. | journal=BMJ Case Rep | year= 2013 | volume= 2013 | issue= | pages= | pmid=24326441 | doi=10.1136/bcr-2013-202072 | pmc=3863066 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24326441 }} </ref><ref name="pmid17301589">{{cite journal| author=Ahmed SI, Gripaldo RE, Alao OA| title=Empyema necessitans in the setting of pneumonia and parapneumonic effusion. | journal=Am J Med Sci | year= 2007 | volume= 333 | issue= 2 | pages= 106-8 | pmid=17301589 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17301589 }} </ref> | 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.<ref name="pmid24326441">{{cite journal| author=Gomes MM, Alves M, Correia JB, Santos L| title=Empyema necessitans: very late complication of pulmonary tuberculosis. | journal=BMJ Case Rep | year= 2013 | volume= 2013 | issue= | pages= | pmid=24326441 | doi=10.1136/bcr-2013-202072 | pmc=3863066 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24326441 }} </ref><ref name="pmid17301589">{{cite journal| author=Ahmed SI, Gripaldo RE, Alao OA| title=Empyema necessitans in the setting of pneumonia and parapneumonic effusion. | journal=Am J Med Sci | year= 2007 | volume= 333 | issue= 2 | pages= 106-8 | pmid=17301589 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17301589 }} </ref> | ||
==Stages of empyema== | |||
Empyema may be classified according to the stage of the disease as follows: | Empyema may be classified according to the stage of the disease as follows: | ||
Revision as of 15:24, 4 January 2017
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Empyema Microchapters |
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 as 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.[1][2]
Stages of empyema
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
This stage is characterized by loculations, inelastic membranous peel, and lung entrapment as a result of scarring of the pleural space.[3]
Tuberculous vs nontuberculous empyema
References
- ↑ Gomes MM, Alves M, Correia JB, Santos L (2013). "Empyema necessitans: very late complication of pulmonary tuberculosis". BMJ Case Rep. 2013. doi:10.1136/bcr-2013-202072. PMC 3863066. PMID 24326441.
- ↑ Ahmed SI, Gripaldo RE, Alao OA (2007). "Empyema necessitans in the setting of pneumonia and parapneumonic effusion". Am J Med Sci. 333 (2): 106–8. PMID 17301589.
- ↑ Strange C, Tomlinson JR, Wilson C, Harley R, Miller KS, Sahn SA (1989). "The histology of experimental pleural injury with tetracycline, empyema, and carrageenan". Exp Mol Pathol. 51 (3): 205–19. PMID 2480911.