This national case-series examined pediatric patients with pleural empyema caused by *Mycoplasma pneumoniae*, characterizing the clinical presentation, management, and outcomes of this rare complication.
Case-series design limits causal inference and generalizability; no comparator group; likely subject to reporting bias for a rare condition.
Clinicians should consider *Mycoplasma pneumoniae* as a causative organism in pediatric pleural empyema, even though it is an uncommon etiology. Appropriate microbiologic testing (e.g., PCR or serology) may be warranted in children with empyema who do not respond to standard antibacterial therapy.
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