pleural effusion vs thoracic empyema
pleural effusion vs thoracic empyema
An empyema can resemble a pleural effusion and can mimic a peripheral pulmonary abscess. Features that help distinguish a pleural effusion from an empyema include:
Shape and location
Empyemas usually:
- form an obtuse angle with the chest wall
- unilateral or markedly asymmetric whereas pleural effusions are (if of any significant size) usually bilateral and similar in size .
- lenticular in shape (biconvex), whereas pleural effusions are crescentic in shape (i.e. concave towards the lung)
Findings on CT
Features suggestive of an empyema include:
- enhancing thickened pleura (see split pleura sign) whereas pleural effusion has thin imperceptible pleural surfaces
- locules of gas absent unless recent thoracocentesis
- obvious septations
- associated consolidation
- associated adjacent infection (e.g. subdiaphragmatic abscess)
Biochemistry/Microbiology
- pH <7.0
- glucose level <40mg/dL
- white cells or organisms present
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Assoziationen und Differentialdiagnosen zu pleural effusion vs thoracic empyema:
