Empyema is an accumulation of pus in the pleural space. Empyema necessitans occurs when pus extends through the parietal pleura into the surrounding tissues.
We present here a 4 month old babywith severe respiratory distress and anassociated huge boggy swelling over the left side of his chest and back. Evaluation revealed pus accumulated in the pleural space which extended to the subcutaneous tissue; a case of empyema necessitans an uncommon occurrence with empyema. Early intercostal drain(ICD) insertion helped to save the baby.
Empyema can sometimes extend beyond the pleural space into the surrounding tissue leading to empyema necessitans. Early and prompt intervention is necessary which could significantly reduce morbidity and mortality.