Black Pleural Effusion as a Rare Presentation of Serotype 3 Pneumococcal Empyema.
Vasilis Grammeniatis, Andreas Eliades, Vasiliki Gketsi et al.
✦ AI-curated · Sources linked
Case in brief
A previously healthy 6-year-old boy presented with severe pneumonia, leading to the discovery of a black pleural effusion during thoracentesis. The fluid tested positive for Streptococcus pneumoniae serotype 3, confirming empyema. The child was treated successfully with chest tube drainage, intrapleural fibrinolysis, and antibiotics, with no underlying malignancy or pancreatic disease found.
What made this case unusual
This case highlights black pleural effusion as a rare presentation of bacterial empyema in a child, expanding the differential diagnosis for pleural effusions in pediatric patients.
Diagnostic / clinical pearl
Clinicians should consider bacterial empyema as a potential cause of black pleural effusion in children, even in fully vaccinated individuals.
Why it matters
This case emphasizes the need for awareness of atypical presentations of severe bacterial pneumonia, which can occur despite vaccination.