Empyema is a collection of pus in the pleural space, which is the thin space between the surface of your lungs and the inner lining of your chest wall.

For empyema to occur, bacteria, fungi, or chemicals must get into your pleural space and cause inflammation, leading to the production of pus. Empyema can lead to life-threatening problems such as sepsis and shock.

The lungs sit in the chest cavity. When fluid builds up in the chest cavity, the lungs cannot fully expand. If your lungs can’t expand properly, you have trouble getting the oxygen you need. This causes you to become short of breath and it may even hurt for you to breathe.


Empyema is usually caused by an infection that spreads from the lung. It leads to a buildup of pus in the pleural space. There can be a pint or more of infected fluid. This fluid puts pressure on the lungs.

Risk factors include:

  • Bacterial pneumonia
  • Chest surgery
  • Lung abscess
  • Trauma or injury to the chest
  • Tuberculosis

In rare cases, empyema can occur after thoracentesis. This is a procedure in which a needle is inserted through the chest wall to draw off fluid in the pleural space for medical diagnosis or treatment.


  • Chest pain
  • Cough
  • Excessive sweating
  • Fever
  • General discomfort or ill feeling
  • Shortness of breath
  • Weight loss

Our approach

Surgical treatment of empyema is crucial to resolving the infection. At Northwell Health, we work with our infectious disease colleagues to select proper intravenous antibiotics tailored to attack the individual infection.

Treatment may include bedside drainage with a tube to remove the infected fluid, but often the infection will require an operation.

Many times a minimally invasive approach, using our high definition video technology and special VATS (video assisted thoracic surgery) instrumentation will be successful in removing the infected material and expanding the lung to its full potential.

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Thoracic surgery

Experts in minimally invasive procedures, Northwell Health has one of the leading robotic thoracic surgical programs in the United States.