Ohki T, Shigematsu Y, Hatooka S. Group B streptococcal empyema necessitatis with pleural fistula after blunt trauma: A case report.
Int J Surg Case Rep 2019;
63:44-47. [PMID:
31563057 PMCID:
PMC6796706 DOI:
10.1016/j.ijscr.2019.09.006]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 09/04/2019] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION
We report the first case of empyema necessitatis (EN) with pleural fistula and septic arthritis caused by Streptococcus agalactiae following blunt trauma.
PRESENTATION OF THE CASE
A 46-year-old man with diabetes mellitus and a history of recent right rib fracture and right knee bruising presented with dyspnea and right knee pain. He was diagnosed with EN and underwent chest drainage, followed by open-window thoracotomy. Septic arthritis occurred on day 8 after thoracotomy. The chest wall wound healed after 3 months.
DISCUSSION
EN is a rare complication of empyema. In this patient, infection was invasive, causing necrotizing pneumonia with a pleural fistula. To our knowledge, there are no reports of group B streptococcal EN with a pleural fistula resulting from blunt chest trauma.
CONCLUSION
Group B streptococcal infection might become invasive in immunocompromised patients, so careful follow-up for those patients is important.
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