Empyema

Empyema is a collection of pus in the pleural space, the gap between the lung and the chest wall. It is a serious infection that usually needs drainage and antibiotics. In asbestos cases it matters both as a cause of pleural scarring that can be confused with asbestos disease and as a possible complication of chest procedures and surgery.

Origin

The word comes from Greek, meaning a gathering of pus. Physicians in ancient Greece described draining infected fluid from the chest, and modern treatment with chest tubes, antibiotics and surgery developed during the nineteenth and twentieth centuries.

Significance in Asbestos Context

Most empyemas follow pneumonia, but they can also follow a thoracentesis, a chest tube, an indwelling pleural catheter or chest surgery, all of which are common in mesothelioma care. After an extrapleural pneumonectomy, an infection in the empty chest cavity is a recognized and serious complication. Empyema matters in a claim in two ways. First, an old empyema can leave thick scarring of the pleura on one side, and defendants may argue that pleural thickening came from a past infection rather than asbestos; one-sided thickening after a known infection is read differently from bilateral plaques. Second, when a person with mesothelioma or lung cancer develops empyema during treatment, the complication and its cost are part of the harm caused by the underlying disease. Clear medical records showing when and why the infection happened help doctors and lawyers sort out which findings come from which cause.

Example Sentence

Three weeks after his pleural catheter was placed, he developed fever and his drainage turned cloudy, and a culture confirmed empyema.

Related Terms

Pleural Effusion, Pleural Cavity, Pleural Thickening, Thoracentesis, Indwelling Pleural Catheter, Extrapleural Pneumonectomy (EPP), Differential Diagnosis

Notes

• Tell your doctor promptly about fever, chills or a change in the color or smell of pleural drainage.
• If you had pneumonia or a chest infection years ago, tell your doctors and your lawyer; it can affect how scarring on your scans is read.
• Keep hospital records of any infection treated during cancer care.