What Is Empyema?

Empyema is an infection of the lining of the pleural space—the region between the lungs and the chest wall inside the ribcage. This infection usually occurs after a bout of pneumonia or pleurisy and is caused by bacteria or fungi that have spread from either the lungs or bloodstream.

The infection causes fluid and pus to accumulate in the pleural space (an empyema). Symptoms of empyema may include chest pain, tightness, shortness of breath, fever, chills, loss of appetite, and sweating.


The treatment of empyema usually involves a combination of antibiotics and surgery. In some cases, a thin tube may be inserted into the pleural space to help drain away the infected fluid. Surgery may also be necessary to clean out the infection or to repair any damage to the pleural membrane.

The outlook for patients with empyema depends on several factors, including the type of bacteria or fungi causing the infection, how much damage has been done to the pleural membrane, and the patient’s overall health.


Empyema can cause complications if it isn’t properly treated. These complications may include:

  • Lungs that don’t fully expand (atelectasis)
  • Air pockets inside the chest (pneumothorax)
  • Fluid in the lungs (pleural effusion)
  • Respiratory failure
  • Sepsis
  • Bacterial infection of the heart (endocarditis)
  • Lung scarring (fibrosis)