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Enterococcus faecalis causing empyema in a patient with liver disease.
Mehrdad Behnia1, Alison S Clay, C Michael Hart
1Department of Medicine, Richard L. Roudebush Veterans Affairs Medical Center, and Indiana University Medical Center, Indianapolis, USA.
Southern Medical Journal
|November 12, 2002
Summary
A patient with liver disease developed spontaneous empyema, a serious infection in the pleural space, caused by Enterococcus faecalis. Prompt treatment with antibiotics and chest drainage led to recovery.
Area of Science:
- Infectious Diseases
- Pulmonology
- Hepatology
Background:
- Liver disease is a risk factor for various infections.
- Empyema, a pleural space infection, can arise from various causes.
- Spontaneous bacterial infections in the pleural space are uncommon.
Observation:
- A 57-year-old man with liver disease presented with fever, shortness of breath, and pleuritic chest pain.
- Computed tomography (CT) revealed a large unilateral pleural effusion and atelectasis.
- No ascites, pneumonia, or peritonitis was evident.
Findings:
- Pleural fluid culture identified a monomicrobial infection with Enterococcus faecalis.
- The patient improved clinically following ampicillin treatment and tube thoracostomy.
Implications:
- This case highlights Enterococcus faecalis as a cause of spontaneous monomicrobial empyema in patients with liver disease.
- It underscores the importance of considering empyema in liver disease patients with respiratory symptoms, even without typical preceding infections.
- Early diagnosis and appropriate management are crucial for favorable outcomes in such cases.