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Case Reports
. 2024 Apr 2:36:e01939.
doi: 10.1016/j.idcr.2024.e01939. eCollection 2024.

Empyema Necessitans: A Case Report

El Mawla Zeinab  1 , Zoghaib Dima  2 , Al Saylami Haji  2
Affiliations
Case Reports

Empyema Necessitans: A Case Report

El Mawla Zeinab et al. IDCases. .

Abstract

Introduction: TB is a well-recognized cause of pulmonary infection. Empyema Necessitans is a rare complication of untreated empyema, mainly caused by mycobacterium tuberculosis. It mainly affects immunocompromised individuals.

Case presentation: We present a case of 28 years old gentleman, Sudanese, with intermittent fever, non-productive cough, weight loss and night sweats. Chest X-ray then CT chest revealed a large right pleural collection invading the chest wall. Chest tube was inserted, fluid analysis was taken, and a bronchoscopy was done. A diagnosis of Empyema Necessitans was confirmed and patient was started on anti-TB regimen with clinical improvement.

Conclusion: Empyema Necessitans is a severe disease, complicating pulmonary tuberculosis. Diagnosis can be a challenge. Surgical and medical approaches are both crucial in the treatment of EN. This case highlights the importance of early recognition and diagnosis of this rare but aggressive condition particularly in TB endemic area.

Keywords: Case report; Empyema; Empyema Necessitans; Lebanon; Pulmonary; Tuberculosis.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
A chest X-ray revealed a 10 × 8.5 cm opacity overlying the right upper lobe, with mild right pleural effusion and enlarged left hilum.
Fig. 2
Fig. 2
A CT scan chest showed miconodular infiltrates with tree in bud appearance with adjacent consolidation in the superior segment of the left lower lobe. Loculated right apical pleural collection with pleural enhancement is seen measuring 9 × 7.5 cm, dissecting the adjacent lateral chest wall and eroding the posterior arch of the 3rd right rib.
Fig. 3
Fig. 3
Chest X-ray showed right chest tube, resolution of empyema, with subsequent small right apical pneumothorax.
See this image and copyright information in PMC

References

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