Presentation
History of tuberculosis, presented with chest wall mass and pain.
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
A large fluid collection is seen in the left pleural cavity, with extension into the soft tissues of the chest wall, compatible with empyema necessitans. Speckles of calcification are seen within the collection. Active contrast extravasation is seen in the intercostal region.
Case Discussion
Empyema necessitans is a rare complication of empyema with extension of the fluid collection and infection to the subcutaneous soft tissue. The most common cause of empyema necessitans is Mycobacterial infection, as in our patient. Less common causes include actinomyces, streptococcus, and staphylococcus infection.
This case also demonstrates erosion of an intercostal artery as a complication of empyema necessitans The patient was subsequently treated with arterial embolization.
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