[Enterococcus faecium lung abscess: one case report and literature review]

Area of Science:

• Infectious Diseases
• Pulmonology
• Microbiology

Background:

• Lung abscesses are typically caused by common bacteria, making Enterococcus faecium an unusual pathogen.
• Early diagnosis and appropriate treatment are crucial for managing lung abscesses and preventing complications.

Observation:

• A case of Enterococcus faecium lung abscess presented with chronic cough, sputum, and hemoptysis, initially misdiagnosed as pneumonia.
• Despite antibiotic therapy, the patient's condition progressed, with consolidation and cavity formation evident on imaging.
• CT-guided percutaneous transthoracic needle aspiration biopsy and subsequent bacterial culture confirmed Enterococcus faecium.

Findings:

• Enterococcus faecium was identified as the causative agent, exhibiting susceptibility to vancomycin, teicoplanin, and linezolid.
• The patient showed significant improvement after sequential treatment with these antibiotics.
• A literature review identified 13 cases of enterococcus pneumonia or lung abscess, including 3 of Enterococcus faecium.

Implications:

• Enterococcus faecium is an uncommon but significant pathogen in lung abscess cases.
• Lung biopsy and bacterial culture are essential for accurate diagnosis and targeted antibiotic selection.
• This case highlights the importance of considering rare pathogens in refractory lung infections.