Lactobacillus gasseri Causing Bilateral Empyema

Area of Science:

• Microbiology
• Infectious Diseases
• Pulmonology

Background:

• Lactobacilli are commensal bacteria residing in the gastrointestinal and genitourinary tracts.
• While generally considered nonpathogenic, rare instances of severe infections caused by Lactobacilli have been documented.

Observation:

• A 49-year-old male with undiagnosed type two diabetes mellitus presented with a 3-month history of cough.
• The patient was diagnosed with right-sided empyema caused by Lactobacillus gasseri, necessitating video-assisted thoracoscopic surgery (VATS) and chest tube placement.

Findings:

• Following initial treatment, the patient developed a contralateral left-sided pleural empyema.
• Aspiration of the left pleural effusion also revealed Lactobacillus gasseri, indicating a persistent or recurrent infection.

Implications:

• This case underscores that Lactobacillus species, including L. gasseri, can act as opportunistic pathogens, leading to severe infections like empyema.
• The successful management of this patient highlights the importance of considering unusual pathogens in complex infections, particularly in individuals with underlying conditions such as diabetes mellitus.