Pleural empyema is defined as pus accumulation in the pleural space. Despite the advanced progress in antibiotic therapy during the last decades, empyema thoracis remains a widespread serious clinical problem with significant associated morbidity and mortality of 2–30%. The processes that lead to the formation of empyema include three phases: an exudative phase, fibrinopurulent phase, and organization phase [1]. The exudative phase is characterized by increased permeability of the visceral pleura leading to the accumulation of a sterile, exudative pleural fluid. Untreated exudative effusions become complicated during the subsequent fibrinopurulent phase and may develop into fibrinopurulent effusions (purulent and increasingly viscous fluid). Owing to the disequilibrium between coagulation and fibrinolysis processes within the pleural space during the fibrinopurulent phase, fibrin and fibrin strands coat the pleural surfaces, leading to adhesions and loculations within the pleural space. This phase often requires interventional procedure to break down the adhesions [2].