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Empyema Caused by Pasteurella multocida in a Patient With Chronic Obstructive Respiratory Disease Taking Inhaled
Hidesato Odaka1, Ruriko Asahi1, Kengo Shimada1
1Department of Respiratory Medicine, Japanese Red Cross Akita Hospital, Akita, JPN.
Abstract:
Pasteurella multocida (P. multocida) infection develops in patients with chronic obstructive pulmonary disease (COPD). Inhaled corticosteroids (ICS) are used for the treatment of COPD. Herein, we report a case of empyema caused by P. multocida in a patient using ICS for COPD. A 79-year-old man with COPD presented with general fatigue. He was treated with triple therapy including ICS. Contrast-enhanced computed tomography revealed encapsulated pleural effusion in the left chest. We initiated antibiotics, sulbactam sodium/ampicillin sodium (3 g × 4), and thoracic drainage. His pleural effusion culture turned out positive and P. multocida was detected. The patient was diagnosed with empyema caused by P. multocida. The triple therapy combination, including ICS, was changed to a double therapy combination without ICS. The subsequent progress was relatively good, and on the 49th day of hospitalization, the patient was discharged. The onset of P. multocida infection may be associated with ICS use, which may best be avoided in a patient with COPD who is at risk of P. multocida infection.
Insights
Pasteurella multocida infection can occur in patients with chronic obstructive pulmonary disease (COPD). Inhaled corticosteroids (ICS) may be associated with P. multocida infection, suggesting avoidance in at-risk COPD patients.
Area of Science:
- Pulmonology
- Infectious Diseases
Background:
- Chronic obstructive pulmonary disease (COPD) management often involves inhaled corticosteroids (ICS).
- Pasteurella multocida (P. multocida) is a pathogen that can cause serious infections.
Observation:
- A case study of a 79-year-old male COPD patient on ICS triple therapy presented with fatigue.
- Imaging revealed encapsulated pleural effusion, leading to diagnosis of empyema.
- P. multocida was identified as the causative agent in the pleural fluid.
Findings:
- The patient was treated with antibiotics and thoracic drainage.
- Discontinuation of ICS from his triple therapy regimen led to clinical improvement.
- P. multocida empyema developed in a COPD patient using ICS.
Implications:
- Inhaled corticosteroid use might be a risk factor for P. multocida infections in COPD patients.
- Consideration should be given to avoiding ICS in COPD patients susceptible to P. multocida.
- This case highlights a potential link between ICS and P. multocida empyema in COPD.
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