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2025, Number 5

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Rev Mex Pediatr 2025; 92 (5)

Empyema necessitatis: a rare complication in children

Jaramillo-Cerezo A, Londoño-Urrea S, Pérez-García P, Manjarrez-Martínez A, Márquez K, Ochoa-Gaviria J, Parra-Buitrago A

Language: Spanish
References: 17
Page: 193-196
PDF size: 997.80 Kb.


ABSTRACT

Introduction: empyema necessitatis is an uncommon complication of pneumonia. It occurs when empyema in the pleural space extends into adjacent soft tissues, creating a fistula between the pleural cavity and the skin. Description of two cases: the first patient was a previously healthy preschooler who presented with fever and a mass in the chest. Imaging studies led to the diagnosis of empyema necessitatis, requiring decortication of the left lower lobe and antimicrobial treatment. Serratia marcescens was isolated. The second patient had a history of granulomatous disease; the main symptom was a mass on the anterior and posterior chest. The diagnosis was made by imaging studies, which also identified bone involvement; Aspergillus flavus was isolated. Treatment consisted of drainage and voriconazole for six months. Conclusion: empyema necessitatis should be considered in patients with complicated pneumonia, in order to integrate the diagnosis and provide timely management.


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