A 60-year-old alcoholic woman presents to the emergency room with fever, chills and shoness of breath. The sputum is rusty-yellow and contains numerous neutrophils, red blood cells and Gram-positive cocci. A chest X-ray shows diffuse haziness over both lungs. One week following admission, the patient develops empyema. This pulmonary condition is associated with the spread of bacterial infection to which of the following anatomic locations?
High-Yield Explanation
Complications of bacterial pneumonia include pleuritis (extension of inflammation to the pleural surface), pleural effusion, pyothorax (infection of pleural effusion), pulmonary abscess and pulmonary fibrosis. Empyema is a loculated collection of pus with fibrous walls that follows the spread of bacterial infection to the pleural space. All of the other choices are possible routes of spread, but do not describe empyema.