Empyema is one of many respiratory conditions, the symptoms of which may be similar to the asbestos cancer commonly known as mesothelioma and/or pleural effusion; indeed, it is the result of a build-up of fluid between the lung surface and the pleural membrane itself, and therefore can result in the same type ofchest pain and shortness of breath. It is however a different kind of affliction that is not necessarily related to carcinoma.
Unlike pleural effusion, which is an excessive build-up of normal lymphatic fluids, empyema is the build up of pus in the same space. This is an important distinction, because unlike lymphatic fluid, pus is the by-product of bacterial infections that is produced during the inflammatory response by the immune system.
Pus is made up of dead white blood cells and a protein fluid called liquor puris. When the immune system detects a harmful foreign, or exogenous pathogen, it responds by moving blood plasma and infection-fighting white blood cells (technically known as leulocytes) to the affected tissues. This results in inflammation, which is the immune system’s attempt to destroy the invader.
Empyema is the result of this type of inflammation in response to a harmful exogenous pathogen in the pleural cavity. Most often, it is caused by pneumonia, but may also be a response to asbestosis.
Because of the pressure, the lungs are unable to expand properly, which is why those suffering from the condition are often short of breath and experience chest pains. Patients with empyema often develop fever, chills, shakes and/or malaise. Untreated empyema can result in septic shock.
In addition to the symptoms which are common to many respiratory conditions, people suffering from empyema may also suffer from coughing, producing blood or greenish-brown sputum. Fatigue, dehydration, halitosis (bad breath) and unexplained weight loss are also symptoms; in some cases, victims develop a fever that may run as high as 105 degrees Fahrenheit. In extreme cases, patients fall into a coma.
Empyema may ultimately kill the patient if not treated promptly. Because the bacteria that causes the infection is carried in the bloodstream, empyema can spread to all parts of the body. The pus may also build up to the point that a rupture occurs and pus enters the airways.
In addition to pneumonia, empyema may also occur as the result of a chest wound, surgery, or a ruptured esophagus (the passage for food and liquid).
Empyema goes through three major stages:
- Acute Stage: this is the initial stage in which pus begins to accumulate inside the pleural cavity. This is also known as the exudative stage, during which levels of glucose and pH remain normal.
- Middle Stage: the pus starts to increase in viscosity, becoming fibrous. This is technically called the fibrinolytic stage; as fluids begin to coagulate, an adhesive network starts to form around the lungs.
- Chronic Stage: the lungs become calcified, or encased in a thick, fibrous substance. Medical personnel refer to this as the organizing stage.
- Wikipedia. “Empyema”
- Health-Cares.net. “What Are The Symptoms of Empyema?”
- Tobler, Marc, MD. “Empyema.”
- Mason RJ, et. al. Murray and Nadel’s Textbook of Respiratory Medicine.
- Ahmed RA, et. al. “Thoracic Empyema.”