A 45-year-old human immunodeficiency virus (HIV)-positive male presented with massive gas-forming cellulitis of the chest wall and left arm, which developed one month after the onset of a Staphylococcus aureus pneumonia that was untreated. This condition was due to an empyema necessitans – an empyema that had drained through the chest wall to the soft tissues of the chest and left arm. Surgical debridement and long term intravenous antibiotic therapy successfully treated the condition.
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