A Community-acquired Lung Abscess Attributable to &lt;i&gt;Streptococcus pneumoniae&lt;/i&gt; which Extended Directly into the Chest Wall

Ko, Yuki; Tobino, Kazunori; Yasuda, Yuichiro; Sueyasu, Takuto; Nishizawa, Satoshi; Yoshimine, K; Morishita, Miyuki; Asaji, Mina; Yamaji, Yoshikazu; Tsuruno, Kosuke; Miyajima, Hiroyuki; Mukasa, Yosuke; Ebi, Noriyuki

doi:10.2169/internalmedicine.56.7398

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…(59.8%), anaerobic bacteria (26.2%), gemella species (9.8%), and Klebsiella pneumoniae (8.2%) were the major pathogens. In the present study, sputum and blood cultures identified Klebsiella pneumoniae , Acinetobacter baumannii, Staphylococcus aureus , Hemolytic streptococcus , Proteus mirabilis , Escherichia coli , and Pseudomonas aeruginosa as the major pathogens, especially in patients with empyema, which was the result of spread via the lymphatic system or direct spread to the parietal pleura 19.…”

Section: Discussionmentioning

confidence: 52%

Logistic regression analysis of clinical and computed tomography features of pulmonary abscesses and risk factors for pulmonary abscess-related empyema

Cai¹,

Yang²,

Li³

et al. 2019

Clinics

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OBJECTIVES: This study was conducted to investigate the risk factors for pulmonary abscess-related empyema by investigating the clinical characteristics and chest computed tomography imaging features of patients with pulmonary abscesses. METHODS: We retrospectively analyzed the chest computed tomography findings and clinical features of 101 cases of pulmonary abscess, including 25 cases with empyema (the experimental group) and 76 cases with no empyema (the control group). The potential risk factors for pulmonary abscess-related empyema were compared between the groups by using univariate and multivariate logistic regression analyses. RESULTS: The incidence of pulmonary abscess-related empyema was 24.8% (25/101). Univariate analysis showed that male gender, diabetes, pleuritic symptoms, white blood cells >10×10 9 /L, albumin level <25 g/L, and positive sputum cultures were potential clinical-related risk factors and that an abscess >5 cm in diameter and transpulmonary fissure abscesses were potential computed tomography imaging-related risk factors for pulmonary abscess-related empyema. Multivariate logistic regression analysis showed that transpulmonary fissure abscesses (odds ratio=9.102, p =0.003), diabetes (odds ratio=9.066, p =0.003), an abscess >5 cm in diameter (odds ratio=8.998, p =0.002), and pleuritic symptoms (odds ratio=5.395, p =0.015) were independent risk factors for pulmonary abscess-related empyema. CONCLUSIONS: Transpulmonary fissure abscesses, diabetes, giant pulmonary abscesses, and pleuritic symptoms increased the risk of empyema among patients with pulmonary abscesses.

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Section: Discussionmentioning

confidence: 52%

Logistic regression analysis of clinical and computed tomography features of pulmonary abscesses and risk factors for pulmonary abscess-related empyema

Cai¹,

Yang²,

Li³

et al. 2019

Clinics

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“…In adults, EN due to Streptococcus pneumoniae has rarely been reported [ 11 ], which is a similar trend for EN due to S. aureus infection [ 12 ]. Table 1 shows all reported cases of EN due to S. aureus , including pediatric cases compiled after a literature search in PubMed.…”

Section: Discussionmentioning

confidence: 95%

Empyema Necessitans in the Setting of Methicillin-Susceptible Staphylococcus aureus Causing Pneumonia and Bacteremia

Bandaru

Manthri

Sundareshan

et al. 2018

Case Reports in Infectious Diseases

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Empyema necessitans (EN) is a rare phenomenon that refers to an insidious extension of the empyema through parietal pleura and subsequent dissection into subcutaneous tissue of the chest wall. A 29-year-old man presented to the hospital with fever and chills a few days after an inadvertent needle stick while injecting heroin. His left forearm was warm with an area of fluctuance. He underwent incision and drainage of the left forearm abscess with fluid submitted for Gram stain and culture. His condition rapidly deteriorated due to sepsis, and he required transfer to the intensive care unit. A new 4 × 3 cm area over the left pectoralis muscle had become increasingly indurated, fluctuant, and erythematous. CT of the chest demonstrated extensive cavitary lung lesions and a large loculated left-sided pleural effusion with extension through the chest wall. TEE revealed a 3 cm complex lesion on the superior septal leaflet of the tricuspid valve. The patient underwent incision and drainage of the pectoralis major EN with placement of a drain. Blood and sputum cultures grew methicillin-susceptible Staphylococcus aureus (MSSA) at which time antibiotic therapy was tailored to oxacillin. Our case highlights a rare occurrence of EN due to MSSA in a patient with intravenous drug use (IDU) and underscores the importance of prompt diagnosis and treatment.

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“…Lung abscesses are microbial infections of the lung parenchyma characterized by a localized area of liquefactive necrosis and formation of cavities measuring more than 2cm in diameter which can contain purulent fluid and necrotic debris [1,2] . Despite being commonly encountered in clinical practice they are usually diagnosed late in the disease course given their indolent presentation [3,4] . Patients typically present with features that mimic pneumonia or upper airway infections, these may include fatigue, cough, shortness of breath, fever, chills, among others.…”

Section: Introductionmentioning

confidence: 99%

Lung abscess caused by Streptococcus intermedius in an immunocompetent patient

Freitas¹,

Toor²,

Torras³

2020

Int. J. Adv. Community Med.

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Lung abscesses are most commonly polymicrobial, being caused by both anaerobic and aerobic bacteria, usually from the oral flora. A particular pathogen present in the oral flora, Streptococcus intermedius, has been known to cause aggressive pyogenic infections such as abscesses, most often on the soft tissues, liver and brain. Though less common, these infections can also occur in the lungs of immunocompetent individuals without preceding risk factors. In such cases, a presentation with productive cough and fever can be misdiagnosed as tracheobronchitis or pneumonia. We present the case of an immunocompetent patient without significant underlying risk factors, who was initially misdiagnosed as recurrent sinusitis, that was found to have a lung abscess due to S. intermedius infection.

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A Community-acquired Lung Abscess Attributable to <i>Streptococcus pneumoniae</i> which Extended Directly into the Chest Wall

Cited by 4 publications

References 16 publications

Logistic regression analysis of clinical and computed tomography features of pulmonary abscesses and risk factors for pulmonary abscess-related empyema

Logistic regression analysis of clinical and computed tomography features of pulmonary abscesses and risk factors for pulmonary abscess-related empyema

Empyema Necessitans in the Setting of Methicillin-Susceptible Staphylococcus aureus Causing Pneumonia and Bacteremia

Lung abscess caused by Streptococcus intermedius in an immunocompetent patient

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