Empyema necessitans complicating a mild COVID-19 infection in a young immunocompetent patient

COVID-19 infection can be complicated by secondary bacterial infections including pneumonia and empyema resulting in worse outcomes. Empyema management includes empirical antibiotic therapy and drainage with a favorable prognosis in most cases.

Empyema necessitans is a rare complication of poorly or uncontrolled empyema thoracis resulting in the dissection of pus through the soft tissues and skin of the chest wall resulting in a fistula between the pleural cavity and the skin. Previous reports indicate that secondary bacterial pneumonia can complicate the course of a COVID-19 infection even in immunocompetent patients resulting in worse outcomes. Management of empyema includes empirical antibiotic therapy and drainage with a favorable prognosis in most cases.