Empyema Thoracic, Shalya Tantra
EMPYEMA THORACIC Collections of pus (purulent fluid) in the pleural Space is defined as empyema. Empyema is always secondary to pyogenic infections of the neighbouring structures, the mOSt common being lobar pneumonia, bronchopneumonia, lung abscess, tuberculesis; bronchopleural fistula,'oesophageal perfoxration, infected lymph nodes, osteomyelitis of thoracic vertebrae, subphrenic abscess, trauma, osteomyelitis of ribs etc. The commonly involved organisms are staphylococcus aureus, streptococcus, pneumococcus, pseudomonas, Esch. coli etc. . As the infections reach the pleural cavity, due to inflammation, protien rich fluid is exudated. This is replaced by fibrin, which causes adhesion of pleural layers at the periphery of collected fluid. Gradually granulation tissue is formed which is than replaced by fibrous tissue. As the empyema is covered by adhesions. The fluid within gradually thickens. Gradually, as the lung is covered by a tough fibrous covering. The affected segme...