Community-associated Methicillin-Resistant Staphylococcus aureus Empyema Necessitatis in a 1-year-8-month-old Child

Empyema necessitatis refers to the extension of a purulent pleural effusion beyond the thoracic cavity into the neighboring chest wall and surrounding soft tissues. Empyema necessitatis is rare and are often associated with tuberculosis infection. We reported a previously healthy toddler with empyema necessitatis due to community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) presenting with fever and productive cough prior to her hospitalization. Her left lower chest wall was swollen and tender to palpation. The chest computed tomography demonstrated a left-sided empyema and extended into the left chest wall. She was successfully treated with thoracoscopic decortication, thoracostomy tube drainage and oral linezolid. Despite empyema necessitatis is not common in daily practice, practitioner should consider this rarity in order to achieve early therapy and to decrease morbidity and mortality. (J Pediatr Resp Dis 2015;11:48-51)