Empyema in rheumatoid arthritis.

Case notes of the last 67 patients to present at the Brompton Hospital with nontuberculous empyemas, and without malignant disease, have been examined. Three cases of empyema in association with rheumatoid arthritis (RA) were found, and these cases are reported. Previous literature concerning this association is reviewed. It is concluded that two types of empyema may occur in patients with RA. Some develop in association with nodular pleuropulmonary disease and the formation of pyopneumothoraces; in other cases large, recurrent, primary empyemas build up in the presence of active rheumatoid disease alone. As with rheumatoid pleural effusions, middle-aged men seem to be particularly susceptible.