Empyema thoracis

Early recognition of empyema is of prime importance. Accurate assessment of stage is crucial in planning management. Exudative empyema (stage I) should be treated by aspiration or tube thoracostomy. Fibrinopurulent empyema (stage II) can be treated effectively by video-assisted thoracic surgery (VATS). Debridement and decortication are the main components of surgical treatment of stage III empyema. It is worthwhile assessing most cases by video-assisted thoracoscopy.