{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:29:49Z","timestamp":1792009789136,"version":"4.4.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,10,8]],"date-time":"2023-10-08T00:00:00Z","timestamp":1696723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Empyema necessitans is a rare and severe complication of pleural effusion characterized by the extension of purulent material from the pleural cavity into the surrounding soft tissues, resulting in the formation of a subcutaneous abscess.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>\n                      A one-year-old boy presented with symptoms that were in line with empyema necessitans, and\n                      <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                      was shown to be the causative organism. A successful outcome required early detection, rapid diagnosis, and proper management, which included targeted antibiotic medication and drainage of the pleural collection. When a young patient exhibits a growing chest wall swelling, empyema necessitans should be considered in the differential diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>\n                      The best care for individuals with empyema necessitans requires a multidisciplinary approach comprising pediatricians, thoracic surgeons, infectious disease experts, and interventional radiologists.\n                      <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                      infection requires a comprehensive approach involving antibiotic therapy and surgical intervention if necessary.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      Empyema necessitans in pediatric patients, caused by\n                      <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                      , is an infrequent disease that requires more investigation to enhance our understanding of the associated risk factors, optimal treatment modalities, and potential long-term consequences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2023.108932","type":"journal-article","created":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T02:53:52Z","timestamp":1697252032000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Empyema necessitans in a pediatric patient"],"prefix":"10.1097","volume":"112","author":[{"given":"Yusuf","family":"Shieba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Ramadan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-25-20260316","doi-asserted-by":"crossref","first-page":"075","DOI":"10.1055\/s-0031-1273942","article-title":"Management of pleural effusion, empyema, and lung abscess","volume":"28","author":"Yu,","year":"2011","journal-title":"Semin. Intervent Radiol"},{"key":"R4-25-20260316","first-page":"1","article-title":"Tuberculous empyema Necessitatis in a 40-year-old immunocompetent male","volume":"2016","author":"Babamahmoodi,","year":"2016","journal-title":"Case Rep. Infect. Dis"},{"key":"R5-25-20260316","first-page":"1","article-title":"Empyema necessitans due to interruption of antituberculosis treatment","volume":"2019","author":"Benaragama,","year":"2019","journal-title":"Case Rep. Infect. Dis"},{"key":"R7-25-20260316","doi-asserted-by":"crossref","first-page":"39A","DOI":"10.1378\/chest.9958","article-title":"Empyema necessitatis","volume":"138","author":"Kellie,","year":"2010","journal-title":"Chest"},{"key":"R8-25-20260316","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1177\/0218492313513592","article-title":"Trends and practice patterns in the management of thoracic empyema","volume":"22","author":"Vyas,","year":"2014","journal-title":"Asian Cardiovasc. Thorac. 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Microbiol"},{"key":"R12-25-20260316","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1016\/j.chest.2015.12.027","article-title":"Pleural effusions at first ED encounter predict worse clinical outcomes in patients with pneumonia","volume":"149","author":"Dean,","year":"2016","journal-title":"Chest"},{"key":"R13-25-20260316","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1177\/00494755211032844","article-title":"Microbiological profile and antibiotic resistance pattern of empyema thoracis in Calabar, Nigeria","volume":"51","author":"Nwagboso,","year":"2021","journal-title":"Trop. Doct"},{"key":"R14-25-20260316","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/S0022-3468(97)90639-4","article-title":"Empyema thoracis in children: a 26-year review of the Montreal Children's hospital experience","volume":"32","author":"Chan,","year":"1997","journal-title":"J. Pediatr. Surg"},{"key":"R15-25-20260316","doi-asserted-by":"crossref","first-page":"710","DOI":"10.3201\/eid2504.180944","article-title":"Pneumonia-specific Escherichia coli with distinct phylogenetic and virulence profiles, France, 2012-2014","volume":"25","author":"La Combe,","year":"2019","journal-title":"Emerg. Infect. Dis"},{"key":"R16-25-20260316","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2015\/108174","article-title":"Empyema Necessitans complicating pleural effusion associated with Proteus species infection: a diagnostic dilemma","volume":"2015","author":"Yauba,","year":"2015","journal-title":"Case Rep. Pediatr"},{"key":"R17-25-20260316","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1007\/s00268-011-1035-5","article-title":"Approach to empyema necessitatis","volume":"35","author":"Akg\u00fcl,","year":"2011","journal-title":"World J. 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