Symptoms of Empyema
The symptoms of empyema often develop after a respiratory infection like pneumonia. As the infection spreads into the pleural cavity, the build-up of pus creates pressure on the lungs, causing pain and breathing difficulty. Recognising the symptoms of empyema early can prevent serious complications and long-term lung damage.
Common Symptoms
Chest pain – Sharp pain that worsens with deep breathing, coughing, or movement. Often felt on one side of the chest.
Shortness of breath – Caused by reduced lung expansion due to the infected fluid pressing against the lungs.
Fever and chills – Indicate the body is fighting an infection.
Persistent cough – May be dry or produce phlegm.
Fatigue and weakness – Ongoing infection can drain energy and make daily activities difficult.
Loss of appetite and weight loss – Common in longer-lasting or severe infections.
Children may present differently. They may become irritable, breathe rapidly, refuse to eat, or show signs of chest retraction—where the chest appears to suck inwards with each breath.
Advanced Symptoms
As empyema progresses, additional signs may appear:
Night sweats
Thick or foul-smelling sputum
Swelling or tenderness over the affected side of the chest
Bluish skin (cyanosis) in severe cases where oxygen levels are low
In South Africa, where TB is common, empyema may develop more slowly, with low-grade fever and gradual weight loss. This “cold empyema” is harder to detect without imaging like chest X-rays or ultrasound.
Symptoms of Empyema
Some patients also show signs of sepsis—a widespread body infection—which includes very high fever, confusion, rapid heartbeat, and dangerously low blood pressure. This is a medical emergency.
Symptoms can vary depending on the stage of empyema and the patient’s immune status. People with chronic illness or HIV may have fewer noticeable symptoms but still suffer from significant infection.
Recognising the symptoms of empyema—especially after pneumonia or TB—is critical. Prompt medical evaluation can lead to early drainage, effective antibiotic treatment, and full recovery before permanent damage occurs.[Next: Diagnosis of Empyema→]
