Whats the treatment for empyema?
The goal of treatment is to cure the infection and remove the collection of pus from the lung. Empyema should be drained immediately with chest tube insertion. Appropriate Antibiotics should be started immediately, empiric to start with followed by specific drug based on culture. Streptokinase is useful to break up adhesions if there are loculations. Some patients not responding to this regimen may require thoracotomy to lyse adhesions. This can be accomplished by thoracoscope. Some would require decortication, if a thick pyemic peel has formed and prevent lung expansion. A surgeon may need to perform a decortication (peeling away the lining of the lung) if the lung does not expand properly.
