Department of Respiratory Medicine, 77239Chettinad Hospital and Research Institute, Chennai, India.
Trop Doct. 2022 Jul;52(3):456-458. doi: 10.1177/00494755221089461. Epub 2022 Mar 23.
A 50-year old diabetic male presented with cough, breathlessness, fever, and chest pain. Clinical and radiological evaluation revealed a right-sided pyopneumothorax. Surgical drainage with tube thoracostomy was performed. Pleural fluid cultures grew as a sole organism. Our patient was treated with vancomycin and amikacin with an excellent clinical response. Enterococci are rarely implicated in the lower respiratory tract and pleural infections and are not usually considered if initiating empirical treatment. Their intrinsic resistance to empirically used antibiotics may complicate the course of the disease. Hence initial Gram staining and expeditious microbiological isolation with susceptibility testing is warranted in all cases. Gram-positive aerobes, notably staphylococcus followed by streptococcus and pneumococcus, are the commonly encountered organisms in pleural infections.
一位 50 岁的糖尿病男性出现咳嗽、呼吸困难、发热和胸痛。临床和影像学评估显示右侧脓气胸。进行了胸腔引流管引流。胸腔液培养仅生长 。我们的患者接受了万古霉素和阿米卡星治疗，临床反应良好。肠球菌很少引起下呼吸道和胸膜感染，如果开始经验性治疗，通常不考虑肠球菌。它们对经验性使用的抗生素的固有耐药性可能使疾病的病程复杂化。因此，所有情况下都需要进行初始革兰氏染色和快速微生物分离培养及药敏试验。革兰氏阳性需氧菌，尤其是葡萄球菌，其次是链球菌和肺炎球菌，是胸膜感染中常见的病原体。
