Abstract: Empyema necessitatis is a rare complication of empyema characterized by a spontaneous extension of pus from the pleural space into adjacent soft tissues.
Key Words: empyema necessitatis, methicillin-resistant Staphylococcus aureus, pleural effusion, pneumonia, tuberculosis
Empyema necessitatis (Latin, "need or necessity") is a rare complication of empyema characterized by a spontaneous extension of pus from the pleural space into adjacent soft tissues.
These findings were noted to be consistent with empyema necessitatis.
Empyema necessitatis has a favorable prognosis if treated with appropriate antimicrobial therapy and the abscess is drained.
ABSTRACT: Empyema necessitatis is a collection of inflammatory tissue that ruptures spontaneously through a weakness in the chest wall into surrounding soft tissues.
EMPYEMA NECESSITATIS is a collection of inflammatory tissue that usually extends directly from the pleural cavity into the thoracic chest wall, forming a mass in the extrapleural soft tissues, following anatomic boundaries.
Actually, empyema necessitatis is an extremely unusual complication of empyema, and most of the scattered case reports over the past 30 years have described immunocompromised patients or patients with underlying tuberculosis.
Rarer causes of empyema necessitatis include malignancy, other pyogenic lung abscesses (due to S pneumoniae, Staphylococcus species, gram-negative bacilli, and polymicrobial infections), blastomycosis, and antinomycosis.
Computed tomography shows a thick-walled, well-encapsulated pleural mass associated with an extrapleural mass in the chest wall, highly suggestive of tuberculous empyema necessitatis.