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[A case of bacterial empyema caused by Gemella morbillorum]

Y Hayashi1, G Ito

  • 1Department of Respiratory Disease, Kasugai Municipal Hospital, Japan.

Kansenshogaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
|March 1, 1996
PubMed

Insights

A rare Gemella morbillorum infection caused a severe lung abscess in a diabetic ketoacidosis patient. Prompt antibiotic treatment and drainage led to a full recovery, highlighting dental caries as a potential entry point.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pulmonology

Background:

  • Diabetic ketoacidosis (DKA) can predispose patients to severe infections.
  • Pleural effusions and lung abscesses are serious complications that require prompt diagnosis and management.
  • Gemella morbillorum is a gram-positive bacterium, part of the normal oral flora, rarely implicated in invasive infections.

Observation:

  • A 44-year-old female with DKA presented with back pain and dyspnea.
  • Chest roentgenogram revealed right-sided pleural fluid accumulation.
  • Pleural fluid analysis showed a putrid odor, suggestive of anaerobic infection.

Findings:

  • Culture of pleural fluid identified Gemella morbillorum as the causative agent.
  • The patient received intravenous antibiotics: clindamycin (CLDM) and panipenem/betamipron (PAPM/BP).
  • In vitro susceptibility testing showed high efficacy for CLDM (MIC < 0.025 µg/mL) and PAPM/BP (MIC < 0.05 µg/mL) against the isolate.

Implications:

  • This case underscores the importance of considering Gemella morbillorum in polymicrobial or putrid pleural infections, especially in immunocompromised patients.
  • Dental caries were suspected as the portal of entry, emphasizing the need for oral hygiene in managing systemic health.
  • Successful treatment with clindamycin and panipenem/betamipron demonstrates effective therapeutic options for this rare infection.

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