"Burgundy wine" pleural effusion: An unusual manifestation of acute bacterial empyema

Although empyema diagnosis by thoracentesis is relatively straightforward, the pleural effusion can sometimes be bloody rather than purulent. We report a case of acute empyema with a dark-red bloody effusion, wherein multiple anaerobic bacteria were detected. Chest imaging findings improved with pleural drainage, intrapleural fibrinolytic therapy, and intravenous antibiotic treatment.