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Vancomycin-resistant Enterococcus faecium Empyema in an Asplenic Patient
Matthew J Cotton1, Clifford D Packer1
1Internal Medicine, Case Western Reserve University School of Medicine, Cleveland, USA.
Cureus
|November 10, 2018
Summary
A rare case of enterococcal empyema caused by vancomycin-resistant Enterococcus faecium (VRE) in an asplenic patient was successfully treated with linezolid. This highlights the need to consider VRE in complex pneumonia cases.
Area of Science:
- Infectious Diseases
- Pulmonology
- Critical Care Medicine
Background:
- Enterococcal empyema is an uncommon pulmonary complication.
- Pneumonia can lead to severe respiratory failure and empyema.
Observation:
- A 67-year-old asplenic male presented with pneumonia, respiratory failure, and empyema.
- Empyema cultures were initially negative, later yielding vancomycin-resistant Enterococcus faecium (VRE).
Findings:
- The patient required decortication and prolonged chest tube drainage.
- Successful treatment was achieved with linezolid, an antibiotic effective against VRE.
- This is the second reported case of VRE empyema without intra-abdominal source, suggesting airway or chest tube contamination.
Implications:
- Physicians should consider multi-drug resistant organisms like VRE in refractory empyema cases.
- Early identification and appropriate antibiotic selection are crucial for managing VRE empyema.
Keywords:
antimicrobialsantimicrobrial resistanceaspleniaclinical microbiologyempyemaenterococcienterocococcus faeciuminfectious diseasesvacomyocin resistant enterococcus faeciumvreMore Related Videos
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