Abstract

Empyema necessitatis is pleural empyema fistulized out of the thorax including subcutaneous tissues. Although it is a rare complication, delayed diagnosis may cause significant morbidity and mortality. A 43-year-old male was admitted to the clinic with a complaint of fever and expectoration of foul-smelling sputum, and a pleural effusion was detected. Fluid was sampled by thoracentesis, and it was concordant with empyema. As the bacteriological culture was positive for Streptococcus intermedius, a combination of two antibiotics was initiated, and a tube thoracostomy was placed. Upon observing protuberance, erythema, temperature rise and fluctuation under skin on the right lower abdominal quadrant, it was drained surgically. Empyema necessitatis was diagnosed since the drained fluid  had the same nature with the pleural fluid. Improvement of clinical, radiological and laboratory findings were obtained after antibiotic therapy. Klimik Dergisi 2019; 32(1): 102-4.

Cite this article as: Güçsav MO, Canbaz M, Deniz S, et al. [Empyema necessitatis: a case of pleural empyema fistulized to the abdominal skin]. Klimik Derg. 2019; 32(1): 102-4. Turkish.