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Official Canadian Paediatric Society document (2018) on “Paediatric complicated pneumonia: Diagnosis and management of empyema”. Pneumonia can be complicated by an empyema, progressing from an exudative effusion, to a fibrinopurulent stage with loculations, and then organized with a thick fibrinous peel. The predominant causative organisms are Streptococcus pneumoniae, Staphyloccocus aureus (including methicillin-resistant S aureus) and Streptococcus pyogenes. For diagnostic imaging, a chest radiograph followed by a chest ultrasound is preferr.
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