title: Emergent management of empyema.
abstract: Empyema is a frankly purulent infection of the pleural space most often occurring secondary to parapneumonic effusion. Imaging, specifically contrast-enhanced computed tomography, plays a critical role in diagnosis with a "split pleura" sign being highly suggestive in the appropriate clinical setting. Diagnostic thoracentesis with culture and Gram stain further guides appropriate antibiotic therapy. Therapeutic drainage with small-bore tube thoracostomy has been shown to be a safe and effective treatment of early stage empyema. Augmentation of tube placement with intrapleural fibrinolytics and mucolytics facilitates catheter drainage by degrading loculations and decreasing fluid viscosity, respectively.
authors.affiliation: Department of Radiology, University of Chicago, Chicago, Illinois.
authors.forename: Osman
authors.initials: O
authors.lastname: Ahmed
authors.forename: Steven
authors.initials: S
authors.lastname: Zangan
keywords: chest tube; empyema; fibrinolytics; mucolytics; split pleura sign