Fatal thoracic empyema involving Campylobacter rectus: A case report

Area of Science:

• Infectious Diseases
• Microbiology
• Pulmonology

Background:

• Thoracic empyema, a serious pleural space infection, can arise from bacterial pneumonia.
• Anaerobic bacteria, particularly those of oral origin, are increasingly recognized as pathogens in severe infections.
• Septic shock necessitates prompt diagnosis and effective antimicrobial therapy.

Observation:

• A 69-year-old male presented with septic shock due to necrotizing pneumonia and subsequent thoracic empyema.
• Pleural fluid analysis revealed a polymicrobial infection including Campylobacter rectus and Actinomyces meyeri.
• Campylobacter rectus, an uncommon oral anaerobe, was identified as a key pathogen.

Findings:

• This is the first reported case of fatal thoracic empyema associated with Campylobacter rectus.
• The identification of Campylobacter rectus was successfully achieved using Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS).
• The mixed anaerobic flora contributed to the severe clinical presentation and poor outcome.

Implications:

• This case underscores the potential pathogenicity of Campylobacter rectus in severe thoracic infections.
• MALDI-TOF MS is a valuable tool for rapid and accurate identification of unusual bacterial pathogens.
• Clinicians should consider anaerobic oral flora in the differential diagnosis of severe pneumonia and empyema.