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Volume 48, Number 4, August 2015

Empyema necessitatis due to Mycobacterium tuberculosis 

Wen-Sen Lee, Shio-Shin Jean, Kuan-Jen Bai, Carlos Lam, Chin-Wang Hsu, Ray-Jade Chen

Received: November 14, 2013    Revised: November 26, 2013    Accepted: February 20, 2014   


Corresponding author:

Shio-Shin Jean
Corresponding author. Department of Emergency Medicine, Wan Fang Hospital, Taipei Medical University, Number 111, Section 3, Hsing-Long Road, Taipei 116, Taiwan. 


Background and purpose: 

Empyema necessitatis (EN) is characterized by the emission of pus from the pleural cavity into adjacent anatomical structures such as the chest wall, the esophagus, the pericardium, and the mediastinum.1 In 1940, Sindel reported that the majority of cases of EN were caused by Mycobacterium tuberculosis (73%), followed by Streptococcus pneumoniae and Actinomyces spp. (especially Actinomyces israelii).1 The overall mortality rate was 66% (87% for M. tuberculosis, 28% for pyogenic organisms) in that era.