Empyema is an active disease state that advances through three stages. Stage 1, or the early exudative phase, consists of an increase in fluid and inflammatory cell in the pleural space. The second phase, the fibropurulent stage, is characterized by large amounts of white cells and fibrin deposition in the pleural space resulting in the formulation of loculations. In stage 3, a fibrinous peel lines the lung leading to limited mobility and fluid reabsorption. The presence of loculations and fibrinous adhesions may hinder the success of therapy because debridement and decortication become necessary