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Clostridium perfringens empyema after right hemicolectomy for caecal volvulus
Bryant Morocho1, Teilios Nikoleta2, Catherin Morocho3
1General Surgery, Guthrie Robert Packer Hospital, Sayre, Pennsylvania, USA Bryant.morocho@guthrie.org.
Abstract:
Empyema of the lung is an infection-induced collection of fluid in the chest cavity. Clostridium perfringens is a bacterium that inhabits the intestine and is a rare cause of empyema after abdominal surgery. A slow phase of infection, associated with C. perfringens empyema, has previously been reported in cases of similar infections. Herein, we present a case of C. perfringens empyema following abdominal surgery. The empyema was initially managed using oxygen supplementation, fluid drainage and antibiotic therapy.This initial therapy failed in the present case because multiple collections of infected fluid prevented the lungs from expanding, requiring decortication, a pulmonary operation to remove the inflammatory tissue from the walls of the lung and associated with the infection, to allow the lung to expand. Following this operation, the patient recovered baseline levels of breathing and oxygen supplementation.
Insights
Clostridium perfringens can cause lung empyema after abdominal surgery. Surgical intervention (decortication) was required when initial treatments failed to resolve the infection and allow lung expansion.
Area of Science:
- Medicine
- Infectious Diseases
- Pulmonary Medicine
Background:
- Empyema is a serious chest infection.
- Clostridium perfringens is a rare cause of empyema, typically seen after abdominal surgery.
- A slow-onset infection is characteristic of C. perfringens empyema.
Observation:
- A case of C. perfringens empyema following abdominal surgery is presented.
- Initial management included oxygen, fluid drainage, and antibiotics.
- This conservative approach failed due to multiple fluid collections hindering lung expansion.
Findings:
- Decortication, a surgical procedure to remove inflammatory tissue, was necessary.
- The surgery allowed the lung to expand.
- The patient recovered breathing function and oxygenation levels post-surgery.
Implications:
- This case highlights the need for surgical intervention in refractory C. perfringens empyema.
- Decortication can be effective in treating complex empyema cases.
- Understanding C. perfringens as a pathogen in post-abdominal surgery empyema is crucial for timely diagnosis and treatment.
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