Source of Support: None, Conflict of Interest: None
An interesting case of Empyema necessitans in an old case of pulmonary tuberculosis with chronic loculated pyopneumothorax In a male aged 28 years is reported. His skiagram chest revealed a soft tissue opacity with air - fluid level under the chest wall much below the fluid level in the left pleural cavity. Following an incision and drainage of the chest wall abscess, the loculated pus in the left pleural cavity completey disappeared. Specimens of sputum and drained pus were positive for acid fast bacilli, thus establishing a tuberculous etiology. There was good clinical response to anti-tubercular treatment leaving a puckered scar at the site of the incised chest wall abscess and a residual unobliterated left pleural space due to non-expansion of the atelectatic lung.