[Acute empyema caused by Streptococcus milleri in early pregnancy]

A 40-year-old woman was admitted to our department complaining of left lateral chest pain and fever. She smoked 10 cigarettes per day. Chest radiographs revealed increased density in the upper left lung field and air-fluid level in the lower left lung field. A diagnosis of acute empyema was made, because pus was aspirated by thoracentesis. Streptococcus intermedius (Streptococcus milleri group) was isolated from samples of pleural effusion. The patient was successfully treated with a combination of antibiotics and surgical drainage. It became clear after discharge that she was in her 6th week of pregnancy. Laboratory findings showed decreased lymphocyte transformation in the PHA and Con-A tests. We reasoned, therefore, that smoking and decreased cellular immunity due to pregnancy might be causes of bacterial infections such as empyema.