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. 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.