The above clinical scenario and CXR suggest a diagnosis of Lung Empyema of Right side. Empyema is an accumulation of pus in the pleural space Most often associated with pneumonia caused by Streptococcus pneumoniae, Staphylococcus aureus (Most Common). Empyema has 3 stages: exudative, fibrinopurulent, and organizational The initial signs and symptoms are primarily those of bacterial pneumonia Clinical features- fever, respiratory distress Treatment Systemic antibiotics like Vancomycin. Thoracentesis and Chest tube drainage initially with a fibrinolytic agent; If no improvement occurs, then VATS (Video assisted thoracoscopic surgery) is done