AIM: The aim of this study is to determine the prevalence of spontaneous bacterial empyema  among  patients with liver cirrhosis and identify clinical features and outcomes of spontaneous bacterial empyema.
patients  AND  METHODS : The study included 800 patients (males and  females) presented with liver cirrhosis with and without  ascites and pleural effusion . A total of 100 (57 males and 43 females) patients with liver cirrhosis and hepatic hydrothorax, (99 patients) with and (1 patients) without ascites were enrolled.  Spontaneous bacterial empyema was diagnosed by a pleural fluid PMNL count >500 cells/mm3 without radiographic evidence of pneumonia or a contiguous infection process on chest radiography.
RESULTS: the frequency of spontaneous bacterial empyema  among cirrhotic patients with hepatic hydrothorax  was 19% (19 out of 100 cirrhotic patients).
CONCLUSION: SBEM was recognized in 19% of cirrhotic patients with ascites and hepatic hydrothorax. So, it is a frequent but underdiagnosed complication of hepatic hydrothorax and has a poor prognosis.