Tissue plasminogen activator for a rare case of neonatal empyema

Empyema is an infection of the pleural space, often secondary to pneumonia. Although frequently encountered in pediatric surgical practice, it is rarely encountered in neonatal patients, and little data exists to guide treatment of neonatal empyema. One strategy is to extrapolate from pediatric treatment paradigms, specifically involving the use of intrapleural fibrinolytic therapy. Herein, we report on a rare case of neonatal empyema successfully treated using tissue plasminogen activator (tPA) via chest tube at a dose of 0.1 mg/kg in 5 mL normal saline daily for 3 days.