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The Clinical Features and Management of Empyema Caused by Streptococcus constellatus

Jinyan Lin1, Yu Zhang1, Chongxi Bao1

  • 1Pulmonary and Critical Care Medicine Ward, Guangxi Medical University First Affiliated Hospital, Nanning, People's Republic of China.

Infection and Drug Resistance
|November 4, 2022
PubMed
Abstract

Insights

Streptococcus constellatus can cause serious pleural empyema, particularly in older males with underlying health conditions. Treatment requires prompt drainage, antibiotics targeting both S. constellatus and anaerobes, and supportive care.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Pulmonology

Background:

  • Streptococcus constellatus, a common commensal, is increasingly recognized as a pathogen in purulent infections.
  • While S. constellatus can cause aggressive pleural empyema, its specific clinical features and management remain understudied.
  • This study addresses the gap in knowledge regarding S. constellatus empyema.

Purpose of the Study:

  • To investigate the clinical characteristics of empyema caused by Streptococcus constellatus.
  • To explore the effective management strategies for S. constellatus empyema.

Main Methods:

  • A retrospective review of 9 patients diagnosed with S. constellatus empyema between January 2010 and August 2021.
  • Analysis of patient demographics, risk factors, clinical presentations, microbiological findings, and treatment outcomes.

Main Results:

  • S. constellatus empyema predominantly affects elderly males with comorbidities like diabetes and oral infections/surgery.
  • Common presentations include unilateral encapsulated empyema, pneumonia, and lung abscess; S. constellatus is often co-isolated with anaerobes.
  • The pathogen shows sensitivity to penicillin G, linezolid, levofloxacin, vancomycin, ceftriaxone, and chloramphenicol, but resistance to erythromycin, tetracycline, and clindamycin.

Conclusions:

  • S. constellatus can lead to pneumonia, lung abscess, and subsequent empyema, especially in vulnerable male populations.
  • Co-infection with anaerobes is frequent, necessitating broad-spectrum antibiotic coverage.
  • Optimal management involves timely pus drainage, appropriate antibiotics, nutritional support, and potentially intrapleural fibrinolytics or surgery.
Keywords:
S. constellatusanaerobesclinical featuresempyema

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