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Causes of an Empyema. Most cases of an empyema are related to bacterial pneumonia (infection of the lung). Pneumonia tends to cause a pleural effusion â para-pneumonic effusion. This can be uncomplicated (containing exudate), complicated (exudate with high concentrations of neurophils) or empyema thoracis (pus in the pleural space).
Symptoms of an empyema are similar to that of a pleural effusion and includes 1  : Pleuritic chest pain â worse when breathing in or coughing. 2  Dry cough. 3  Excessive perspiration, night sweats. 4  Fever with rigors. 5  Difficulty breathing â may be absent, mild, moderate or severe. 6  Weight loss. 7  Malaise.