Empyema, defined as the accumulation of pus within the pleural cavity, is a severe complication of infections such as pneumonia or sepsis. It is associated with significant morbidity and requires prompt identification and management to prevent progression and complications like fibrothorax or respiratory failure. The management of empyema in the intensive care unit (ICU) necessitates a multidisciplinary approach involving early recognition, accurate staging, and appropriate therapeutic interventions tailored to patient-specific factors [1, 2] [Ref: Algorithm 87.1].