Pleural infection is a significant cause of morbidity and mortality worldwide.

Although typically seen in the context of bacterial pneumonia, the definition encompasses pleural space infection or empyema (frank pus) arising from any cause.

Maintaining a high index of suspicion is key, especially in individuals who fail to respond to treatment for pneumonia and/or have evidence of a new effusion on chest imaging.

Drainage of the infected pleural fluid along with antibiotics remains central to management, but often presents challenges in practice requiring individualised care.

Chest drains, regardless of size, must be flushed regularly to maintain patency and facilitate effective drainage.

Early discussion with multi-disciplinary team members is essential to providing optimal treatment, including early surgical intervention where appropriate.