Thoracic Empyema

• This man had appropriate treatment for his empyema and lung abscess, but he did not improve.
• The reason was that he had a second pathology below the diaphragm which is a recognised rare complication of acute pancreatitis.
• The abcess was drained, resulting in the release of several hundred millilitres of pus with resultant resolution of his fever.
• The psoas muscle contains the lumbar nerve plexus which innervates the inner part of the thigh where he experienced the pain.
• The infection in the psoas muscle was irritating the nerve trunks of the lumbar nerve plexus.

He was discharged home one week later.