Nonresolving Empyema: Is It Encysted? A Case Report.

Empyema evolves through exudative, fibrinopurulent and organized phases throughout 3 to 6 weeks. Clinical symptoms, a chest skiagram followed by thoracentesis, are enough for diagnosis. Most patients improved with systemic antibiotics, thoracentesis and chest tube drainage. The present case represents a four-year-old girl who had a fever, cough, chest pain and breathing difficulty for two weeks. Right-sided empyema was diagnosed after admission to our facility, which had not responded to appropriate antibiotics and closed chest tube drainage. Re-evaluation of the patient indicates a possible case of encysted empyema. Thoracotomy and decortication were done in collaboration with Thoracic Surgery Department, Chittagong Medical College Hospital, Bangladesh. Her recovery was excellent, with supervised post-operative care in the Pediatric Intensive Care Unit in the same facility. Radiographic loculation is one of the predictors of failure to conservative management. Choosing the correct treatment option based on the stages of empyema is vital, which can reduce morbidity and mortality. In addition, Patients got standard management at a reduced cost as full investigation, including contrast-enhanced computed tomogram (CECT), specialized surgical procedure and intensive care facilities were provided by a government hospital.