Pleuropulmonary infections caused by Eikenella corrodens

A case of pleuropulmonary infection caused by Eikenella corrodens is reported, followed by a review of clinical cases reported in the English-language literature since 1970. On the basis of this review, the predisposing factors, clinical features, and principles of diagnosis and treatment of this infection are outlined. Although infection may occur at any age, it seems to occur most often in patients less than or equal to 14 or greater than or equal to 44 years of age. Adult patients commonly have some underlying medical illness, pleuropulmonary malignancy being the most common. Patients present with a variable combination of fever, cough, and pleuritic chest pain. Four radiographic patterns may be seen: pleural effusion, pneumonia, cavitation, or a combination of these. Ampicillin and penicillin G are effective therapeutic agents; although the susceptibility of E. corrodens to penicillin G has been accepted as the rule, it may not always prevail. The need for increased awareness of this organism as a cause of pleuropulmonary disease is stressed because it is resistant to clindamycin, an agent that is increasingly used to treat anaerobic pleuropulmonary infections.