Streptococcus gordonii empyema: A case report and literature review

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Pulmonology

Background:

• Empyema, a serious pleural infection, is typically caused by Streptococcus anginosus or Streptococcus pneumoniae.
• Streptococcus gordonii, part of the Streptococcus mitis group, is an uncommon pathogen in empyema cases.

Observation:

• A case of a 59-year-old male with right-sided chest pain and dyspnea is presented.
• Purulent pleural effusion culture identified Streptococcus gordonii.
• Imaging confirmed right-sided pleural effusion.

Findings:

• A literature review combined with this case identified seven patients with Streptococcus gordonii empyema.
• The majority of patients were male (86%) with right-sided empyema (71%).
• Common risk factors included poor dental hygiene/procedures (43%), diabetes mellitus (43%), and smoking (43%).
• Complications were rare, including bacteremia and spleen abscesses (14% each).
• All patients received chest tube insertion, and most survived without recurrence (86%).

Implications:

• Streptococcus gordonii should be considered in the differential diagnosis of empyema, especially in patients with relevant risk factors.
• Prompt diagnosis and appropriate management, including surgical intervention and antibiotics, are crucial for favorable outcomes.
• Further research may elucidate the specific mechanisms by which Streptococcus gordonii causes empyema.