Postoperative Empyema Due to Leclercia adecarboxylata Following Mesothelioma Surgery: A Case Report

Leclercia adecarboxylata (L. adecarboxylata) is a rare opportunistic pathogen that can cause severe infections like empyema, particularly in immunocompromised individuals. We aim to highlight the importance of the early detection and personalized treatment of L. adecarboxylata infections in patients with comorbidities such as malignant mesothelioma.

We present the case of a 57-year-old man with type 2 diabetes mellitus, hypertension, and malignant mesothelioma who developed a parapneumonic effusion that progressed to empyema. After undergoing pleurectomy and pleurodesis, intraoperative cultures identified L. adecarboxylata. Targeted antibiotic therapy was initiated based on the culture results, and the patient's response was closely monitored.

The patient responded well to targeted antibiotic therapy with ampicillin/sulbactam following the initial empirical treatment with piperacillin/tazobactam. The identification of L. adecarboxylata-a rare finding in empyema cases-was crucial for effective management. The patient recovered fully without complications, highlighting the importance of the early identification and individualized treatment of infections caused by rare pathogens.

This case underscores the need to consider L. adecarboxylata in immunocompromised patients presenting with unusual infections. Early detection through advanced diagnostic techniques and personalized antibiotic therapy can improve clinical outcomes and help prevent antimicrobial resistance. Increased clinical awareness and further research into the resistance patterns and treatment approaches for L. adecarboxylata are essential to enhance patient care.