Table 2 Summary of the reported human cases with empyema necessitans associated with MRSA
Case | Reference | Age | Sex | Year | Underlying diseases | Isolate lesion | Disseminated lesion | Invasive procedures | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|
1 | Kugai et al. [7] | 49 years | Male | 1993 | LC, immediately after direct surgical intervention for Budd–Chiari syndrome, left lower leg ulcer caused by MRSA 3 months previously | Sputum, pleural fluid | None | Open pleural drainage, continuous intrathoracic irrigation (Povidone Iodine Solution 1% 100 mL + saline 500 mL) | flomoxef 7 days → imipnem/cilastatin + NET 2 days → MIN + NET 3 days → MIN + ABK 4 days → VAN 4 days →  + OFX 16 days → FOF + OFX 20 days → VAN + OFX 8 days → flomoxef + OFX 6 days → OFX 10 days | Complete resolution |
2 | Stallworth et al. [3] | 8 months | Male | 2005 | None | Blood | None | Thoracotomy | AZM → CTX →  + VAN 10 days → SXT (PO) to complete a 21-day course of antibiotics | Complete resolution |
3 | Moore et al. [8] | 3 months | Female | 2006 | None | Intraoperative cultures from the right chest wall | None | Decortication, tube thoracostomy, wide drainage of the subscapular collection | CRO + VAN to complete a total of 14 days → LZD 7 days | Complete resolution |
4 | Mizell et al. [5] | 59 years | Male | 2008 | HT, DM, CRF, LC | Blood, urine, aspiration fluid from chest mass | Osteomyelitis of the left lateral portion of the sternum and the distal end of the first rib | Fine-needle aspiration of the chest wall mass, wedge resection of the left upper lung lobe with tube thoracostomy drainage | VAN 25 days → CIP + SXT (PO) 10 days | Not reported |
5 | Contreras et al. [9] | 19 months | Male | 2009 | None | Blood, chest wall fluid | Septic emboli, acute osteomyelitis of the right distal femur | Thoracoscopic decortication | AZM → CRO + VAN → GEN + VAN 2 weeks → VAN 36 days → CLI (PO) | Complete resolution |
6 | Rosebush et al. [10] | 4 weeks | Female | 2014 | Exposure to a maternal breast abscess caused by MRSA via breast-feeding | Fluid from intervention | Osteomyelitis of the posterolateral right 9th, 10th, and 11th ribs | Tube thoracostomy (pigtail catheter) | AMP + GEN + CLI → AMP + CLI + CTX → CLI (IV) to complete a total of 4 weeks → CLI (PO) 4 weeks | Complete resolution |
7 | Lee et al. [11] | 1 year and 8 months | Female | 2015 | None | Fluid from intervention | None | Thoracoscopic decortication, tube thoracotomy | AMC → LZD 21 days | Not reported |
8 | Edriss et al. [12] | 60 years | Male | 2017 | Tobacco abuse, remote alcohol abuse, and left total hip arthroplasty presented | Sputum | None | Wedge resection of the left upper lobe | VAN + MEM to complete a total of 6–8 weeks | Complete resolution |
9 | Pugh et al. [13] | 5 years | Male | 2019 | Obstructive hydrocephalus status postventriculoatrial shunt placement, influenza A infection 1 week before admission | Pleural fluid | None | Removal of the shunt system, tube thoracotomy, infused with fibrinolytic agent alteplase | FEP + VAN →  + CLI → VAN to complete a total of 21 days | Complete resolution |
10 | Pankaj et al. [14] | 63 years | Male | 2021 | Not reported | Blood | None | Tube thoracotomy | VAN + CRO + AZM to complete a total of 14 days | Not reported |
11 | Farouji et al. [15] | 35 years | Female | 2021 | Active intravenous drug use | Fluid from intervention | None | Interventional radiology-guided incision and drainage → a left upper lobectomy | TZP + VAN → VAN to complete a total of 4 weeks | Not reported |
12 | Ashraf et al. [16] | 2 months | Female | 2022 | None | Pus from intervention/4th rib osteomyelitis | Left 4th rib osteomyelitis | Tube thoracotomy, incision and drainage of the abscess | CRO + AMC → TZP + VAN for 3 weeks | Complete resolution |
13 | Ashraf et al. [16] | 10 years | Male | 2022 | History of trauma to the right knee 7 days previously | Pus from the right knee and pleural fluid | Right knee, anterior aspect of the right upper arm, quadratus lumborum muscle, bilateral gluteal muscles and obturator interni | Tube thoracotomy, surgical drainage of right knee abscess, incision on upper back | CRO + VAN → sulbactam/cefoperazone to complete a total of 6 weeks | Complete resolution |
14 | Rehman et al. [17] | 1.5 years | Female | 2023 | None | Blood, pleural fluid | None | Tube thoracotomy and decortication (two chest tubes placed) | CRO + VAN 3 days → LZD (IV) 4 days → LZD (PO) for 4 weeks | Complete resolution |
Our case | Nakamura et al | 69 years | Male | 2023 | Stones in the urinary tract | Blood | Cervical osteomyelitis, paravertebral inflammation | Left thoracotomy | SAM →  + VAN →  + DAP 4 weeks → LZD 4 weeks, VAN 14 days → SXT (PO) 44 days → DAP 3 days → MIN | Relapse → Complete resolution |