Tuberculous Empyema necessitatis in a man infected with the human immunodeficiency virus

Empyema necessitatis is a collection of inflammatory tissue that ruptures spontaneously through a weakness in the chest wail into surrounding soft tissues. Although empyema necessitatis can be caused by a number of infectious agents, mycobacteria are the most frequently implicated. Empyema was a much more common complication of pulmonary tuberculosis in the preantibiotic era than it is today. We describe a 22-year-old man with human immunodeficiency virus (HIV) infection who had tuberculous empyema necessitatis and was successfully treated with surgical debridement and antibiotic therapy.