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Case Reports in Pediatrics
Volume 2015, Article ID 108174, 4 pages
http://dx.doi.org/10.1155/2015/108174
Case Report

Empyema Necessitans Complicating Pleural Effusion Associated with Proteus Species Infection: A Diagnostic Dilemma

1Department of Paediatrics, University of Maiduguri College of Medical Sciences, Maiduguri 752106, Nigeria
2Department of Paediatrics, Federal Medical Centre, Azare 751101, Nigeria

Received 14 June 2014; Revised 13 November 2014; Accepted 5 January 2015

Academic Editor: Mohammad M. A. Faridi

Copyright © 2015 M. S. Yauba et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Empyema necessitans, a rare complication of pleural effusion, could result in significant morbidity and mortality in children. It is characterized by the dissection of pus through the soft tissues and the skin of the chest wall. Mycobacterium tuberculosis and Actinomyces israelii are common causes but Gram negative bacilli could be a rare cause. However, there were challenges in differentiating between Mycobacterium tuberculosis and nontuberculous empyema in a resource poor setting like ours. We report a child with pleural effusion and empyema necessitans secondary to Proteus spp. infection. Methods. We describe a 12-year-old child with empyema necessitans complicating pleural effusion and highlight management challenges. Results. This case was treated with quinolones, antituberculous drugs, chest tube drainage, and nutritional rehabilitation. Conclusion. Empyema necessitatis is a rare condition that can be caused by Gram negative bacterial pathogens like Proteus species.