Cardiovascular and Interventional Radiological Society of Europe

Empyema (collection of pus)


Empyema refers to pus gathering within a naturally-existing space in the body.

When this develops in the pleural cavity (the space between the two thin membranes surrounding your lungs,) it is called pleural empyema. This is usually caused by an infection that spreads from the lung to the pleural cavity, but can be caused by anything that introduces infectious agents to the area, including chest trauma or surgery and tears to the gullet.

Gallbladder empyema commonly results from advanced gallbladder inflammation, with gallstones blocking the passage of bile. Gallbladder empyema can also result from blockage by other causes, such as cancer of the pancreatic head.


Most patients with empyema experience fatigue, fever, chills, sweating and loss of appetite, but elderly patients and those with diabetes may not have specific symptoms.

Other symptoms depend on the site of the infection. If you have pleural empyema, you may experience shortness of breath, coughing and chest pain, whereas if you have gallbladder empyema you are likely to experience nausea, vomiting, constant and severe pain in the right upper or upper middle abdominal area, and pain radiating to the right shoulder blade.


Blood tests can help a doctor determine whether there is an infection. Ultrasound, chest X-ray (for pleural empyema) and CT can be used by doctors to confirm the empyema’s existence and indicate its location, thickness and cause.


Your doctor will first try to control the infection with antibiotics. If this is not enough, you may be advised to undergo a minimally invasive interventional radiology procedure called percutaneous drainage, in which an interventional radiologist uses image guidance to insert a small plastic tube through a hole in the skin, usually under local anesthesia, and drain the pus.