The ongoing struggle with empyema management: is surgery really the answer?

Despite having been described over 3,000 years ago, pleural infection continues to be a challenging condition to treat. The last decade has seen a greater understanding of the pathogenesis and microbiology of pleural infection. There are now data to suggest that although the majority of cases are related to pneumonic consolidation, the varied microbiology and radiological findings suggest that primary pleural infection is a distinct entity requiring specific attention.