Pleural empyema is gross pus in the pleural space or a parapneumonic effusion, documented by Gram stain or culture to be infected, that requires drainage for definitive treatment.11 Pleural empyema can be found in all age groups.

Empyema of the chest is associated with considerable morbidity and mortality rates despite treatment.16 Infected pleural fluid collections develop as a complication of pulmonary abscess, chest trauma, or surgical procedures. Other causes include secondary infection from a preexisting hydrothorax, hemothorax, esophageal perforation, or mediastinitis; or direct extension from vertebral osteomyelitis or subdiaphragmatic abscess. 11 These complications preceding an empyema are usually a result of direct hematogenous or lymphatic spread from the primary source.

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