Unusual Presentation of Empyema Necessitans caused by Fusobacterium Infection

Author(s):

Inderjeet Singh*, Maryam AL Balushi and Iman Shaat

Empyema necessitans is a rare complication of pleural empyema with extension of the empyema outside the pleural space into the neighbouring chest wall and surrounding soft tissues. Most cases occur as a result of inadequately treated empyema related to necrotizing pneumonia or lung abscess. Mycobacterium tuberculosis and Actinomyces are the most common pathogens isolated from empyema necessitans. We are reporting in this article a rare case of Chronic Obstructive Pulmonary Disease (COPD) patient presented with unresolving pneumonia and found to have pleural effusion extended to the chest and abdominal wall. Images and fluid analysis confirm the diagnosis of empyema necessitans caused by Fusobacterium infection and the patient was improved significantly after fluid drainage and culture sensitive antibiotic treatment.