Parapneumonic and post-traumatic pleural space infections.

Thoracic empyema, an accumulation of pus in the pleural space, was first described by Hippocrates. Today, parapneumonic and post-traumatic empyemas account for two thirds of all pleural space infections. Although modern antibiotic therapy has significantly reduced the incidence of thoracic empyemas, it remains a problem that thoracic surgeons will encounter and should feel comfortable about recognizing and treating. The successful management of thoracic empyemas centers on adequate and timely drainage, the use of appropriate antibiotics, the selective use of decortication, and the proper treatment of underlying pulmonary parenchymal disease.