Related Experiment Video

Updated: Jul 16, 2026

A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients
03:47

A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients

Published on: October 25, 2024

Contemporary empyema necessitatis

Scott A Kono1, Trenton D Nauser

  • 1Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kans 66160, USA. skono@kumc.edu

The American Journal of Medicine
|April 3, 2007
PubMed

Insights

Empyema necessitatis is a rare complication where infection extends through the chest wall. Early diagnosis and treatment of pleural effusions can prevent this serious condition.

Area of Science:

  • Medical Microbiology
  • Pulmonology
  • Thoracic Surgery

Background:

  • Empyema necessitatis is defined as the extension of an empyema through the parietal pleura into surrounding tissues.
  • Clinical manifestations are typically subacute, often linked to indolent pathogens like Mycobacterium tuberculosis and Actinomyces israelii.

Observation:

  • This case report describes a patient with empyema necessitatis.

Findings:

  • Treatment with antimicrobials and surgical debridement has significantly reduced mortality associated with empyema necessitatis.
  • Timely diagnosis and management of parapneumonic pleural effusion are crucial for preventing this rare complication.

Implications:

  • Consider empyema necessitatis in patients presenting with constitutional symptoms and a chest wall mass.
  • Prompt assessment and treatment of pulmonary infections are vital to avoid the development of empyema necessitatis.

Related Concept Videos

Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Pneumonia III: Complications and Assessment01:30

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
Pneumonia I: Introduction01:29

Pneumonia I: Introduction

Pneumonia is an infection of the lower respiratory tract that leads to inflammation of the lung parenchyma, often resulting in the accumulation of inflammatory exudate in the alveoli and airways. Unlike the watery, low-protein fluid exudate in pulmonary edema, the exudate in this case is a thick fluid rich in immune cells, proteins, and debris produced during infection and inflammation.This impairs gas exchange and can lead to consolidation of lung tissue. The infection may be caused by a...
Pneumonia I: Introduction01:30

Pneumonia I: Introduction

Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...