There are many symptoms associated with an empyema ranging from mild to severe. These patients have an increased tendency to develop lung abscess, cavitation, empyema, and pleural adhesions. In severe cases of empyema, surgery may be needed. Complications may occur, such as exudative pleural effusion, empyema, and lung abscesses. These infections include aspiration pneumonia, lung abscess, pulmonary empyema, and chronic otitis media and sinusitis. If however an empyema develops additional intervention is required. Occasionally, microorganisms will infect this fluid, causing an empyema. Other pulmonary complications include lung abscess and empyema. Another possible complication is an empyema, in which pus collects inside the lungs. These often cause subdural empyema, and brain abscess, and rarely cause epidural abscess and meningitis. Frontal sinusitis and empyema can also result. Authors noted that there were no known cases of sympathetic empyema caused by "Streptococcus anginosus". Symptoms of the underlying problem are sometimes seen, for example, fever in cases of empyema. The risk of empyema in children seems to be comparable to adults. It can cause lung abscess, pulmono pleural fistula, empyema lung and broncho pleural fistula.