# Methicillin-resistant Staphylococcus aureus-associated empyema necessitans in a child: A case report and a literature review

## TL;DR

A 4-year-old child developed a rare and severe infection called empyema necessitans caused by a drug-resistant bacteria, which was successfully treated with drainage and long-term antibiotics.

## Contribution

This is the sixth reported pediatric case of methicillin-resistant Staphylococcus aureus-associated empyema necessitans, contributing to limited literature on the condition.

## Key findings

- Empyema necessitans in children is rare and requires prompt diagnosis and treatment.
- The case was successfully managed with open drainage and prolonged antibiotic therapy.
- Further case reports are needed to establish standardized treatment guidelines.

## Abstract

Empyema is a known complication of severe pleuropneumonia. In rare cases, if poorly treated, it could result in dissemination and fistulization and transformation into empyema necessitans. The manifestation may appear as a superficial abscess. However, as management highly differs, the recognition of potentially severe phenomenon is required.

We describe a case of empyema necessitans on a 4-year-old girl secondary to methicillin-resistant Staphylococcus aureus. It represents the sixth pediatric case reported in the literature. It was managed by open drainage and prolonged antibiotherapy. The outcome was favorable as guidelines were extracted from similar reported cases.

Empyema necessitans remains a rare complication with significant morbidity. Prompt diagnosis and adapted management have relied on limited literature. As such, further reports are necessary to establish proper guidelines.