Case Report

Methicillin-resistant Staphylococcus aureus Empyema Necessitatis in an Eight-month-old Child

Authors: James Stallworth, MD, Elizabeth Mack, MD, Christopher Ozimek, MD


Empyema necessitatis is a rare complication of empyema characterized by a spontaneous extension of pus from the pleural space into adjacent soft tissues. It is uncommon in the pediatric population and is usually caused by Mycobacterium tuberculosis. This report describes the youngest reported case of empyema necessitatis. The clinical examination and CT scan are diagnostic. The causative organism was methicillin-resistantStaphylococcus aureus, which has not been previously reported. Treatment involves drainage of the abscess and appropriate antimicrobial therapy.

Key Points

* Empyema necessitatis is an uncommon complication of pneumonia in which pus extends from the pleural space into adjacent soft tissues, usually the anterolateral chest wall.

Mycobacterium tuberculosis is the most common cause of empyema necessitatis.

* Empyema necessitatis has a good prognosis after abscess drainage and appropriate antimicrobial agents.

* Clinicians should be aware of uncommon suppurative complications of pneumonia in patients of all ages.

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