Empyema Necessitatis

Kellie, Scott P.; Shaib, Fidaa; Forster, Derek; Mehta, J.P.

doi:10.1378/chest.9958

Cited by 8 publications

(6 citation statements)

References 1 publication

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“…This is in conformity with the reports by some workers [ 7 , 8 ] who documented the etiologic agents to be Gram negative bacilli, Streptococcus pneumoniae , Staphylococcus aureus, and Blastomycosis. This finding contrasted with the reports by others where they documented more indolent pathogens, Mycobacterium tuberculosis and Actinomyces israelii , as a common cause of empyema necessitans [ 6 ]. Our finding also contrasted with the report [ 4 ] that most cases occur in immunocompromised patients because our case was seronegative for HIV.…”

Section: Discussioncontrasting

confidence: 99%

“…This patient's empyema and chest wall swelling were present for three months before presenting to our hospital for intervention. If pleural effusion is left for several months without intervention, this can lead to developing this complication, empyema necessitans [ 6 , 7 ]. This might have contributed to the development of empyema necessitans in our patient.…”

Section: Discussionmentioning

confidence: 99%

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Empyema Necessitans Complicating Pleural Effusion Associated withProteusSpecies Infection: A Diagnostic Dilemma

Yauba

Ahmed

Imoudu

et al. 2015

Case Reports in Pediatrics

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Background. Empyema necessitans, a rare complication of pleural effusion, could result in significant morbidity and mortality in children. It is characterized by the dissection of pus through the soft tissues and the skin of the chest wall. Mycobacterium tuberculosis and Actinomyces israelii are common causes but Gram negative bacilli could be a rare cause. However, there were challenges in differentiating between Mycobacterium tuberculosis and nontuberculous empyema in a resource poor setting like ours. We report a child with pleural effusion and empyema necessitans secondary to Proteus spp. infection. Methods. We describe a 12-year-old child with empyema necessitans complicating pleural effusion and highlight management challenges. Results. This case was treated with quinolones, antituberculous drugs, chest tube drainage, and nutritional rehabilitation. Conclusion. Empyema necessitatis is a rare condition that can be caused by Gram negative bacterial pathogens like Proteus species.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Empyema Necessitans Complicating Pleural Effusion Associated withProteusSpecies Infection: A Diagnostic Dilemma

Yauba

Ahmed

Imoudu

et al. 2015

Case Reports in Pediatrics

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“…The most common etiology being mycobacterium tuberculosis. 2 The chronic nature of the infection corresponds with the slow progression of disease. The granulomatous infection creates a tract from the pleural space through parietal pleura to the surrounding soft tissues and skin of chest wall forming a fistula.…”

Section: Discussionmentioning

confidence: 99%

Empyema necessitans, a rare complication of empyema thoracis

Chaudhary¹,

Bhowmik²,

Datta³

et al. 2018

IJRRT

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| http://medcraveonline.com rise in temperature was noted. Since, the swelling was confined to soft tissue, contrast enhanced Magnetic Resonance Imaging (MRI) was advised which showed a peripheral rim enhancing, large, multilobulated T1WI hypointense and T2WI hyperintense lesion in right posterior chest wall having multiple internal septations. The lesion was involving the intercostal space and intercostal muscles. Cortical irregularity and altered marrow signal intensity was noted at 6 th and 7 th ribs of right posterior chest wall. Similar characteristics lesion was noted in the right posterior pleural space which appeared communicating with the posterior chest wall lesion. Ultrasound (US) examination of the swelling was done which showed hypoechoic, multi lobulated mass which showed no vascularity on color flow. Hence, ultrasound guided fine needle aspiration (FNA) was done; from which thick purulent yellowish colored pus was aspirated and was sent for gram stain, acid fast bacillus, culture and sensitivity. Pus culture revealed Mycobacterium tuberculosis. Based on this, thoracotomy with decortication was done. Patient was treated with intravenous antibiotics and discharged home on oral antibiotics with significant improvement (Figure 1 & Figure 2).

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“…Mycobacterium Tuberculosis is the most prevalent pathogen, with Nocardia Asteroides, Actinomyces Israelii, Staphylococcus, Aspergillosis, and Blastomycosis spp. being less common [ 1 , 8 , 52 , 53 ].…”

Section: Pleural Diseasesmentioning

confidence: 99%

A Review of Posteromedial Lesions of the Chest Wall: What Should a Chest Radiologist Know?

et al. 2022

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A heterogeneous group of tumors can affect the posteromedial chest wall. They form diverse groups of benign and malignant (primary or secondary) pathologies that can arise from different chest wall structures, i.e., fat, muscular, vascular, osseous, or neurogenic tissues. Chest radiography is very nonspecific for the characterization of chest wall lesions. The modality of choice for the initial assessment of the chest wall lesions is computed tomography (CT). More advanced cross-sectional modalities such as magnetic resonance imaging (MRI) and positron emission tomography (PET) with fluorodeoxyglucose are usually used for further characterization, staging, treatment response, and assessment of recurrence. A systematic approach based on age, clinical history, and radiologic findings is required for correct diagnosis. It is essential for radiologists to be familiar with the spectrum of lesions that might affect the posteromedial chest wall and their characteristic imaging features. Although the imaging findings of these tumors can be nonspecific, cross-sectional imaging helps to limit the differential diagnosis and determine the further diagnostic investigation (e.g., image-guided biopsy). Specific imaging findings, e.g., location, mineralization, enhancement pattern, and local invasion, occasionally allow a particular diagnosis. This article reviews the posteromedial chest wall anatomy and different pathologies. We provide a combination of location and imaging features of each pathology. We will also explore the role of imaging and its strengths and limitations for diagnosing posteromedial chest wall lesions.

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Empyema Necessitatis

Cited by 8 publications

References 1 publication

Empyema Necessitans Complicating Pleural Effusion Associated withProteusSpecies Infection: A Diagnostic Dilemma

Empyema Necessitans Complicating Pleural Effusion Associated withProteusSpecies Infection: A Diagnostic Dilemma

Empyema necessitans, a rare complication of empyema thoracis

A Review of Posteromedial Lesions of the Chest Wall: What Should a Chest Radiologist Know?

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