Work

A rare case of bacterial translocation from a renal abscess resulting in empyema necessitans: a case report and literature review

Year: 2025

Type: article

Abstract: Empyema necessitans (EN) is a rare complication of thoracic empyema in which infection spreads into the chest wall. While historically associated with tuberculosis, EN caused by Escherichia coli is exceedingly rare. Our report highlights a case of EN in a 76-year-old male that developed after dislodgement of a chest tube placed for the treatment of a pleural effusion associated with a perinephric abscess. The patient presented with a cough and chest wall bulge and admission imaging confirmed a loculated pleural effusion with extension into the chest wall. Cultures from a spontaneously draining pleurocutaneous fistula grew E. coli and the patient required surgical intervention for decortication and excision of the fistula tract. This case highlights the importance of considering extra-thoracic sources of infection in empyema, maintaining suspicion for EN in patients with a history of inadequate drainage, and the role of early surgical intervention in preventing complications.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjaf908

Authors: Monica Bobila, Walid Akram Hussain, Niyousha Ahmadi, Gregory Crisafulli, Aakash Trivedi, Vinay Tak

Institution: St. Joseph’s University Medical Center

Language: English

Topic: Pleural and Pulmonary Diseases

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000