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Empyema with Trichomonas species

P D Walzer, I Rutherford, R East

The American Review of Respiratory Disease

|August 1, 1978

Summary

A rare case of empyema caused by Trichomonas was successfully treated. This finding highlights the importance of considering parasitic causes in difficult-to-treat pleural infections.

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Area of Science:

Medical Microbiology
Parasitology
Pulmonology

Background:

Empyema is a serious infection of the pleural space, often associated with bacterial pneumonia.
Aspiration pneumonia is a common cause of lung infections in individuals with alcohol use disorder.
Pleural infections typically require prompt antimicrobial therapy and source control, such as drainage.

Observation:

A 35-year-old male with a history of alcoholism presented with symptoms suggestive of aspiration pneumonia.
Pleural fluid analysis revealed the presence of Trichomonads on microscopy.
The patient was diagnosed with a Trichomonas-induced empyema.

Findings:

Microscopic identification of Trichomonads in pleural fluid confirmed a parasitic etiology.
Treatment involved a combination of metronidazole, other antibiotics, and surgical drainage.
The patient achieved a full recovery from the empyema.

Implications:

This case underscores the necessity of considering uncommon pathogens, including parasites like Trichomonas, in the differential diagnosis of empyema.
Early and accurate diagnosis of parasitic pleural infections is crucial for effective management.
Metronidazole, an effective antiprotozoal agent, plays a key role in treating Trichomonas-related empyema.

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