{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:31:48Z","timestamp":1784871108643,"version":"3.55.0"},"reference-count":48,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024]]},"abstract":"Introduction: 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.<\/jats:p>\n \n Case Presentation: We describe a case of empyema necessitans on a 4-year-old girl secondary to methicillin-resistant\n Staphylococcus aureus<\/jats:italic>\n . 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.\n <\/jats:p>\n Conclusion: 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.<\/jats:p>","DOI":"10.5339\/qmj.2024.35","type":"journal-article","created":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T02:33:01Z","timestamp":1722997981000},"source":"Crossref","is-referenced-by-count":1,"title":["Methicillin-resistant Staphylococcus aureus-associated empyema necessitans in a child: A case report and a literature review"],"prefix":"10.5339","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0597-9524","authenticated-orcid":true,"given":"Ghada","family":"Habachi","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery \u201cA\u201d, Children\u2019s Hospital of Tunis, Tunis, Tunisia*Correspondence: Ghada Habachi habachighada92@gmail.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sondes","family":"Sahli","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery \u201cA\u201d, Children\u2019s Hospital of Tunis, Tunis, Tunisia*Correspondence: Ghada Habachi habachighada92@gmail.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrine Ben","family":"Ammar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery \u201cA\u201d, Children\u2019s Hospital of Tunis, Tunis, Tunisia*Correspondence: Ghada Habachi habachighada92@gmail.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bochra","family":"Aziza","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery \u201cA\u201d, Children\u2019s Hospital of Tunis, Tunis, Tunisia*Correspondence: Ghada Habachi habachighada92@gmail.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riadh","family":"Jouini","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery \u201cA\u201d, Children\u2019s Hospital of Tunis, Tunis, Tunisia*Correspondence: Ghada Habachi habachighada92@gmail.com"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3277","reference":[{"issue":"(2):","key":"CIT0001","series-title":"Pediatrics","first-page":"204\u201313","article-title":"National hospitalization trends for pediatric pneumonia and associated complications","volume":"126","author":"Lee\n \nGE","year":"2010"},{"issue":"(9):","key":"CIT0002","series-title":"Indian J Pediatr","first-page":"910\u20134","article-title":"Debate 1: Is the management of childhood empyema primarily medical, or surgical?","volume":"90","author":"Manoharan\n \nA","year":"2023"},{"issue":"(7):","key":"CIT0003","series-title":"J Pediatr Surg","first-page":"e5\u20137","article-title":"Empyema necessitatis in an infant: A rare surgical disease","volume":"41","author":"Moore\n \nFO","year":"2006"},{"key":"CIT0004","series-title":"Cochrane Database Syst Rev","first-page":"CD002312","article-title":"Intra-pleural fibrinolytic therapy versus conservative management in the treatment of adult parapneumonic effusions and empyema","volume":"(2)","author":"Cameron\n \nR","year":"2008"},{"issue":"(2):","key":"CIT0005","series-title":"Am J Med Sci","first-page":"106\u20138","article-title":"Empyema necessitans in the setting of pneumonia and parapneumonic effusion","volume":"333","author":"Ahmed\n \nSI","year":"2007"},{"issue":"(11):","key":"CIT0006","series-title":"J Pediatr Surg","first-page":"2101\u201310","article-title":"The diagnosis and management of empyema in children: A comprehensive review from the APSA outcomes and clinical trials committee","volume":"47","author":"Islam\n \nS","year":"2012"},{"key":"CIT0007","series-title":"Case Rep Infect Dis","first-page":"4906547","article-title":"Empyema necessitans in the setting of methicillin-susceptible Staphylococcus aureus causing pneumonia and bacteremia","volume":"2018","author":"Bandaru\n \nS","year":"2018"},{"issue":"(170):","key":"CIT0008","series-title":"Eur Respir Rev","first-page":"230117","article-title":"Systematic review of ceftaroline fosamil in the management of patients with methicillin-resistant Staphylococcus aureus pneumonia","volume":"32","author":"Torres\n \nA","year":"2023"},{"issue":"(11):","key":"CIT0009","series-title":"South Med J","first-page":"1130\u20131","article-title":"Methicillin-resistant Staphylococcus aureus empyema necessitatis in an eight-month-old child","volume":"98","author":"Stallworth\n \nJ","year":"2005"},{"issue":"(4):","key":"CIT0010","series-title":"Biomedica","first-page":"506\u201312","article-title":"Empyema necessitans and acute osteomyelitis associated with community-acquired methicillin-resistant Staphylococcus aureus in an infant","volume":"29","author":"Contreras\n \nGA","year":"2009"},{"issue":"(6):","key":"CIT0011","series-title":"Pediatr Infect Dis J","first-page":"668\u20139","article-title":"Methicillin-resistant Staphylococcus aureus empyema necessitatis in a breast-fed neonate","volume":"33","author":"Rosebush\n \nJ","year":"2014"},{"issue":"(3):","key":"CIT0012","series-title":"Pediatr Infect Dis J","first-page":"256\u20137","article-title":"Empyema necessitans a rare complication of methicillin-resistant Staphylococcus aureus empyema in a child","volume":"39","author":"Pugh\n \nCP","year":"2020"},{"issue":"(6):","key":"CIT0013","series-title":"J Emerg Med","first-page":"e221\u20133","article-title":"Empyema necessitans diagnosed by point-of-care ultrasound","volume":"59","author":"Elyashiv\n \nD","year":"2020"},{"issue":"(1):","key":"CIT0014","series-title":"Eur J Dermatol","first-page":"115\u20139","article-title":"Empyema necessitatis revisited","volume":"20","author":"Llamas-Velasco\n \nM","year":"2010"},{"issue":"(6):","key":"CIT0015","series-title":"Chest","first-page":"1888\u201391","article-title":"Pseudomonas cepacia empyema necessitatis after lung transplantation in two patients with cystic fibrosis","volume":"105","author":"Noyes\n \nBE","year":"1994"},{"issue":"(11):","key":"CIT0016","series-title":"Cureus","first-page":"e48973","article-title":"Empyema necessitatis: A rare complication of empyema","volume":"15","author":"Gerlach\n \nG","year":"2023"},{"issue":"(11):","key":"CIT0017","series-title":"J Orthop Case Rep","first-page":"87\u201390","article-title":"Post-traumatic osteomyelitis of the rib-point of care in children, presenting with chest wall pain","volume":"12","author":"Mishra\n \nPK","year":"2022"},{"issue":"(3):","key":"CIT0018","series-title":"J Assoc Med Microbiol Infect Dis Can","first-page":"236\u201340","article-title":"A palpable chest wall mass in a 4-year-old boy","volume":"6","author":"Domm\n \nJM","year":"2021"},{"issue":"(1):","key":"CIT0019","series-title":"J Infect Public Health","article-title":"Empyema necessitatis due to Pseudomonas aeruginosa in a child with cerebral palsy","volume":"13","author":"Nishimura\n \nA","year":"2020"},{"issue":"(5):","key":"CIT0020","series-title":"AJR Am J Roentgenol","first-page":"1007\u20139","article-title":"Actinomycosis involving the chest wall: CT findings","volume":"139","author":"Webb\n \nWR","year":"1982"},{"issue":"(11):","key":"CIT0021","series-title":"Viruses","first-page":"2110","article-title":"Impact of SARS-CoV-2 epidemic on antimicrobial resistance: A literature review","volume":"13","author":"Segala\n \nFV","year":"2021"},{"issue":"(1):","key":"CIT0022","series-title":"J Pediatr Surg","first-page":"106\u201311;","article-title":"Thoracoscopic decortication vs tube thoracostomy with fibrinolysis for empyema in children: A prospective, randomized trial","volume":"44","author":"St Peter\n \nSD","year":"2009"},{"issue":"(12):","key":"CIT0023","series-title":"Pharmacotherapy","first-page":"1758\u201370","article-title":"Management of community-associated methicillin-resistant Staphylococcus aureus infections in children","volume":"26","author":"Le\n \nJ","year":"2006"},{"issue":"(1):","key":"CIT0024","series-title":"J Chemother","first-page":"53\u20137","article-title":"Comparison of the efficacy of tigecycline and teicoplanin in an experimental methicillin-resistant Staphylococcus aureus osteomyelitis model","volume":"20","author":"Kandemir\n \nO","year":"2008"},{"issue":"(2):","key":"CIT0001","series-title":"Pediatrics","first-page":"204\u201313","article-title":"National hospitalization trends for pediatric pneumonia and associated complications","volume":"126","author":"Lee\n \nGE","year":"2010"},{"issue":"(9):","key":"CIT0002","series-title":"Indian J Pediatr","first-page":"910\u20134","article-title":"Debate 1: Is the management of childhood empyema primarily medical, or surgical?","volume":"90","author":"Manoharan\n \nA","year":"2023"},{"issue":"(7):","key":"CIT0003","series-title":"J Pediatr Surg","first-page":"e5\u20137","article-title":"Empyema necessitatis in an infant: A rare surgical disease","volume":"41","author":"Moore\n \nFO","year":"2006"},{"key":"CIT0004","series-title":"Cochrane Database Syst Rev","first-page":"CD002312","article-title":"Intra-pleural fibrinolytic therapy versus conservative management in the treatment of adult parapneumonic effusions and empyema","volume":"(2)","author":"Cameron\n \nR","year":"2008"},{"issue":"(2):","key":"CIT0005","series-title":"Am J Med Sci","first-page":"106\u20138","article-title":"Empyema necessitans in the setting of pneumonia and parapneumonic effusion","volume":"333","author":"Ahmed\n \nSI","year":"2007"},{"issue":"(11):","key":"CIT0006","series-title":"J Pediatr Surg","first-page":"2101\u201310","article-title":"The diagnosis and management of empyema in children: A comprehensive review from the APSA outcomes and clinical trials committee","volume":"47","author":"Islam\n \nS","year":"2012"},{"key":"CIT0007","series-title":"Case Rep Infect Dis","first-page":"4906547","article-title":"Empyema necessitans in the setting of methicillin-susceptible Staphylococcus aureus causing pneumonia and bacteremia","volume":"2018","author":"Bandaru\n \nS","year":"2018"},{"issue":"(170):","key":"CIT0008","series-title":"Eur Respir Rev","first-page":"230117","article-title":"Systematic review of ceftaroline fosamil in the management of patients with methicillin-resistant Staphylococcus aureus pneumonia","volume":"32","author":"Torres\n \nA","year":"2023"},{"issue":"(11):","key":"CIT0009","series-title":"South Med J","first-page":"1130\u20131","article-title":"Methicillin-resistant Staphylococcus aureus empyema necessitatis in an eight-month-old child","volume":"98","author":"Stallworth\n \nJ","year":"2005"},{"issue":"(4):","key":"CIT0010","series-title":"Biomedica","first-page":"506\u201312","article-title":"Empyema necessitans and acute osteomyelitis associated with community-acquired methicillin-resistant Staphylococcus aureus in an infant","volume":"29","author":"Contreras\n \nGA","year":"2009"},{"issue":"(6):","key":"CIT0011","series-title":"Pediatr Infect Dis J","first-page":"668\u20139","article-title":"Methicillin-resistant Staphylococcus aureus empyema necessitatis in a breast-fed neonate","volume":"33","author":"Rosebush\n \nJ","year":"2014"},{"issue":"(3):","key":"CIT0012","series-title":"Pediatr Infect Dis J","first-page":"256\u20137","article-title":"Empyema necessitans a rare complication of methicillin-resistant Staphylococcus aureus empyema in a child","volume":"39","author":"Pugh\n \nCP","year":"2020"},{"issue":"(6):","key":"CIT0013","series-title":"J Emerg Med","first-page":"e221\u20133","article-title":"Empyema necessitans diagnosed by point-of-care ultrasound","volume":"59","author":"Elyashiv\n \nD","year":"2020"},{"issue":"(1):","key":"CIT0014","series-title":"Eur J Dermatol","first-page":"115\u20139","article-title":"Empyema necessitatis revisited","volume":"20","author":"Llamas-Velasco\n \nM","year":"2010"},{"issue":"(6):","key":"CIT0015","series-title":"Chest","first-page":"1888\u201391","article-title":"Pseudomonas cepacia empyema necessitatis after lung transplantation in two patients with cystic fibrosis","volume":"105","author":"Noyes\n \nBE","year":"1994"},{"issue":"(11):","key":"CIT0016","series-title":"Cureus","first-page":"e48973","article-title":"Empyema necessitatis: A rare complication of empyema","volume":"15","author":"Gerlach\n \nG","year":"2023"},{"issue":"(11):","key":"CIT0017","series-title":"J Orthop Case Rep","first-page":"87\u201390","article-title":"Post-traumatic osteomyelitis of the rib-point of care in children, presenting with chest wall pain","volume":"12","author":"Mishra\n \nPK","year":"2022"},{"issue":"(3):","key":"CIT0018","series-title":"J Assoc Med Microbiol Infect Dis Can","first-page":"236\u201340","article-title":"A palpable chest wall mass in a 4-year-old boy","volume":"6","author":"Domm\n \nJM","year":"2021"},{"issue":"(1):","key":"CIT0019","series-title":"J Infect Public Health","article-title":"Empyema necessitatis due to Pseudomonas aeruginosa in a child with cerebral palsy","volume":"13","author":"Nishimura\n \nA","year":"2020"},{"issue":"(5):","key":"CIT0020","series-title":"AJR Am J Roentgenol","first-page":"1007\u20139","article-title":"Actinomycosis involving the chest wall: CT findings","volume":"139","author":"Webb\n \nWR","year":"1982"},{"issue":"(11):","key":"CIT0021","series-title":"Viruses","first-page":"2110","article-title":"Impact of SARS-CoV-2 epidemic on antimicrobial resistance: A literature review","volume":"13","author":"Segala\n \nFV","year":"2021"},{"issue":"(1):","key":"CIT0022","series-title":"J Pediatr Surg","first-page":"106\u201311;","article-title":"Thoracoscopic decortication vs tube thoracostomy with fibrinolysis for empyema in children: A prospective, randomized trial","volume":"44","author":"St Peter\n \nSD","year":"2009"},{"issue":"(12):","key":"CIT0023","series-title":"Pharmacotherapy","first-page":"1758\u201370","article-title":"Management of community-associated methicillin-resistant Staphylococcus aureus infections in children","volume":"26","author":"Le\n \nJ","year":"2006"},{"issue":"(1):","key":"CIT0024","series-title":"J Chemother","first-page":"53\u20137","article-title":"Comparison of the efficacy of tigecycline and teicoplanin in an experimental methicillin-resistant Staphylococcus aureus osteomyelitis model","volume":"20","author":"Kandemir\n \nO","year":"2008"}],"container-title":["Qatar Medical 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