Empyema Necessitans

 

Presence of pus in pleural space is defined as empyema thoracis.

If this empyema is left undrained or untreated, it may extend beyond the pleural cavity with pointing occurring in the intercostal space close to the sternum where chest wall is thinnest.

Empyema necessitans denotes lesion that has ruptured through the chest wall to the subcutaneous tissue ultimately reaching the surface through the skin to form a discharging sinus. It is seen in tuberculosis and actinomycetes.

Treatment:- 

Surgical dilatation of fistulous tract may assist drainage which can be collected in colostomy bags followed by decortication.

Ref : Crofton