{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:00:26Z","timestamp":1787756426001,"version":"build-2784847793"},"reference-count":22,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,9,20]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>The coexistence of empyema, nephropleural fistula and perinephric abscess is rare and presents diagnostic challenges, especially when patients exhibit atypical or mild symptoms. This case report details a female in her early 90s who presented with 3\u2009weeks of chest pain and was found to have a left-sided pleural effusion. Further imaging revealed additional findings of a left-sided nephropleural fistula and left perinephric collection. The patient underwent thoracentesis and video-assisted thoracoscopic surgery, with cultures growing <jats:italic>Streptococcus Anginosus<\/jats:italic>. Subsequently, she underwent a left nephrectomy, with pathology findings consistent with chronic pyelonephritis and a fistulous tract. The patient was discharged on intravenous antibiotics. Follow-up imaging showed improvement. The patient completed the antibiotic course and reported symptom resolution 2\u2009weeks after discharge.<\/jats:p>","DOI":"10.1136\/bcr-2023-259015","type":"journal-article","created":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T19:50:11Z","timestamp":1729194611000},"page":"e259015","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Empyema complicated with nephropleural fistula and perinephric abscess"],"prefix":"10.1136","volume":"17","author":[{"given":"Omer","family":"Ahmed","sequence":"first","affiliation":[{"name":"Department of Medicine, Unity Hospital, Rochester Regional Health, Rochester, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5388-9112","authenticated-orcid":false,"given":"Xin Ya","family":"See","sequence":"additional","affiliation":[{"name":"Department of Medicine, Unity Hospital, Rochester Regional Health, Rochester, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Eid","sequence":"additional","affiliation":[{"name":"Department of Medicine, Unity Hospital, Rochester Regional Health, Rochester, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Zambon","sequence":"additional","affiliation":[{"name":"Division of Pulmonology and Critical Care, Unity Hospital, Rochester Regional Health, Rochester, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,10,17]]},"reference":[{"key":"2025082623183875000_17.10.e259015.1","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.ijscr.2012.08.015","article-title":"Empyema and lung abscess as complication of a perforated appendicitis in a pregnant woman","volume":"3","author":"Dietrich","year":"2012","journal-title":"Int J Surg Case Rep"},{"key":"2025082623183875000_17.10.e259015.2","doi-asserted-by":"crossref","DOI":"10.12659\/AJCR.935169","article-title":"Pleural Empyema as a Complication of Pyogenic Liver Abscess: Can the Minimum Achieve the Optimal? 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