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16.2.13

Empyema

Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 16, Respiratory Conditions.

Clinical Description

Due to infective process

Causes: bacterial and mycobacterial organism

Signs and Symptoms

  • Fever, pleuritic chest pain, shortness of breath
  • Signs of pleural effusion on physical examination +/-finger clubbing

Investigations

  • Full blood count
  • Blood culture
  • HIV test
  • Urea and creatinine
  • Pleural tap: gram stain, ZN stain, GeneXpert, WBC and differential, culture and sensitivity
  • CXR

Treatment

  • Carry out surgical drainage (chest drain)
  • Continue antibiotic therapy as for CAP for 21 to 28 days
  • Rule out TB

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