Polymicrobial empyema in a patient with lung adenocarcinomacontaining Capnocytophaga sputigena

A man in his 60s with advanced COPD and lung adenocarcinoma presented with sepsis and acute hypoxaemic respiratory failure. Imaging revealed bilateral pleural effusions, and he was found to have a polymicrobial empyema which included Capnocytophaga sputigena Despite appropriate treatment, he continued to deteriorate and ultimately died of sepsis. Capnocytophaga species, typically benign constituents of the oral microbiota, rarely can instigate pleuropulmonary infections, especially in immunocompromised individuals. We highlight the difficulty in the identification and the optimal antimicrobial treatment of Capnocytophaga in the setting of growing antibiotic resistance.