A Case of Empyema Necessitatis in a Child With <i>Mycobacterium tuberculosis</i>

Acar, Manolya; Sütçü, Murat; Aktürk, Hacer; Topyıldız, Ezgi; Somer, Ayper; Erol, Oğuz Bülent; Genç, Gonca Erköse; Salman, Nuran

doi:10.1177/0009922815614355

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…Tuberculosis, a highly contagious infection, ranks as the 9th leading cause of death among immunocompromised patients, with over 90% of fatalities occurring in developing countries [ 9 ]. Empyema necessitans (EN), a rare and unusual complication of extrapulmonary TB, arises when a parapneumonic effusion or untreated empyema thoracis creates a fistula allowing fluid to extend from the pleural cavity to subcutaneous tissues [ [1] , [2] , [3] , [4] , 10 ]. Although Mycobacterium tuberculosis has been found as the most frequent causative agent, other bacteria and some malignancies can also result in this complication [ 7 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“… 55 methicillin-sensitive Staphylococcus aureus Surgical reconstruction Broad spectrum antibiotic regimen of vancomycin, piperacillin/tazobactam, and metronidazole 2 Empyema necessitans with osteomyelitis of fifth rib due to Nocardia farcinica : a case report [ 2 ]. 80 Nocardia farcinica Three-drug regimen: Trimethoprim-sulfamethoxazole, amikacin and ceftriaxone 3 A Case of Empyema Necessitatis in a Child with Mycobacterium tuberculosis [ 3 ]. 11 Mycobacterium tuberculosis Anti-tuberculosis therapy 4 A case of empyema necessitans in an adolescent with mycobacterium tuberculosis [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Empyema necessitans (EN) is a clinical condition where an intrathoracic empyema breaks through the parietal pleura and extends along the path of least resistance into surrounding extra-thoracic soft tissues [ [1] , [2] , [3] , [4] ]. The most prevalent cause of empyema is untreated parapneumonic effusion [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Empyema necessitans (EN) as a rare complication of tuberculosis – A case report

Jamil,

Mehmood,

Janjua

et al. 2023

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Empyema necessitans (EN) as a rare complication of tuberculosis – A case report

Jamil,

Mehmood,

Janjua

et al. 2023

International Journal of Surgery Case Reports

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“…Most information about TB empyema in children date back many years, with no new cases recently described. Cases of empyema necessitatis due to TB has recently been described 4. Prognosis of TB empyema is variable, with slow disease progression and even death or slow resolution with pleural calcification and fibrosis 5.…”

Section: Discussionmentioning

confidence: 99%

Loculated empyema due to tuberculosis in a child

Goussard¹,

Morrison

Appel

et al. 2017

BMJ Case Reports

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A 9-year-old girl from black ethnic origin presented with a history of fever, cough, loss of weight and right-sided chest wall pain for 2 weeks. Chest X-ray demonstrated an effusion, which was shown to be loculated on chest CT scan. She was not responding to medical treatment and at thoracotomy loculated pus was drained. (TB) was cultured from the pus. TB is a rare cause of loculated empyema with an overlapping clinical and radiological picture with pyogenic infections.

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“…The other suggested mechanisms include the direct spread of infection into the pleural space from ruptured thoracic lymph nodes or hematogenous spread 5 . Failure of timely detection and treatment may worsen illness severity, prolong patient suffering and increase the risk of complications, such as tuberculous bronchoesophageal fistula, 6 empyema necessitatis, 7 and destroyed lung 8 …”

Section: Introductionmentioning

confidence: 99%

Comparison of pediatric empyema secondary to tuberculosis or non‐tuberculosis community‐acquired pneumonia in those who underwent surgery in high TB burden areas

Yang

Chen

et al. 2021

Pediatric Pulmonology

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Introduction Tuberculous empyema (TE) in children is common in high‐TB burden and medical resource‐limited areas. However, studies that evaluate the characteristics of TE in children are sparse. This study aimed to analyze the clinical features of pediatric TE receiving surgical intervention. Methods We performed a retrospective study of children with empyema secondary to community‐acquired pneumonia who underwent surgery in our institution. The clinical characteristics were compared between TE and empyema secondary non‐tuberculosis infection (non‐tuberculosis empyema, NTE). Results One hundred patients were included (27 with TE and 73 with NTE). Stage 3 empyema occupied 81.5% and 45.2% of TE and NTE in this study. The TE children had older age, longer duration of illness, and milder symptoms. Pleural fluid culture was positive for Mycobacterium tuberculosis in 7.4% of patients with TE. Lymph node enlargement, lymph node calcification, and pleural nodules presented in TE with high specificity (93.2%, 98.6%, and 98.5%) but low sensitivity (33.3%, 14.8%, and 29.6%) on CT scan. Thoracoscopy surgery was performed in 14 (51.9%) in TE and 39 (53.4%) in NTE. Postoperative chest‐tube indwelling time was longer (7.85 ± 5.00 vs. 4.89 ± 1.81 days, p < .001), and more patients had incomplete lung expansion after 3 months in TE. Conclusion Tuberculosis infection should be screened in management of children with empyema in high‐TB burden areas. Pediatric TE usually presented at older age and with milder respiratory symptoms. Pleural biopsy during surgery is often necessary to confirm the cause of infection. Thoracotomy is still required in some pediatric TE or NTE with delayed treatment in medical resource‐limited area.

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A Case of Empyema Necessitatis in a Child With Mycobacterium tuberculosis

Cited by 5 publications

References 6 publications

Empyema necessitans (EN) as a rare complication of tuberculosis – A case report

Empyema necessitans (EN) as a rare complication of tuberculosis – A case report

Loculated empyema due to tuberculosis in a child

Comparison of pediatric empyema secondary to tuberculosis or non‐tuberculosis community‐acquired pneumonia in those who underwent surgery in high TB burden areas

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