Empyema necessitans as a rare manifestation of Staphylococcus aureus

Empyema necessitans (EN) is a rare complication of empyema, in which pus accumulates within the pleural space and spreads through the chest wall, leading to the formation of a subcutaneous abscess. This condition presents significant diagnostic and therapeutic challenges due to its rarity and potential for serious complications. Here, we present the case of an 8-year-old boy with a history of parapneumonic effusion that was incompletely treated due to a lack of fibrinolytic agent injection. He presented with fever, chills, a productive cough, and left-sided chest pain with yellowish purulent secretions from the left chest wall. The patient was diagnosed with EN caused by Staphylococcus aureus, which has occurred due to inadequate treatment and the lack of administration of a fibrinolytic agent injection for the patient. He was treated with broad-spectrum antibiotics, video-assisted thoracic surgery, and a chest tube for complete drainage. The patient showed a smooth and uneventful recovery, highlighting the importance of early diagnosis and prompt treatment of EN to avoid further complications. This case report aims to increase awareness among clinicians about the importance of early recognition and appropriate management of EN to improve patient outcomes.