Table 2:

Causes, interventions and signs of treatment failure in empyema

CauseIntervention25
  • Resistant or atypical organism

  • Augmentation of antibiotic therapy

  • Complicated parapneumonic effusion

  • Fibrinolytics and/or video-assisted thoracic surgery

  • Necrotizing pneumonia

  • Computed tomography and surgical consultation

Signs of treatment failure
  • Persistent high fever* and other signs of sepsis

  • Persistent respiratory distress

  • Persistent chest pain

  • * Intermittent low-grade fevers are expected during the normal course of recovery from empyema and do not necessarily indicate treatment failure.1,5