Odeyemi Joseph, Emoto Jessica, Abu-Samra Abdel-Ghanie
Internal Medicine/Pediatrics, University of Kansas School of Medicine, Wichita, USA.
Pulmonology/Critical Care, University of Kansas School of Medicine, Wichita, USA.
Cureus. 2024 Dec 31;16(12):e76683. doi: 10.7759/cureus.76683. eCollection 2024 Dec.
Empyema, a type of pleural effusion characterized by pus accumulation in the pleural space, is most often caused by bacterial infections, typically as a complication of pneumonia. This case report presents a 70-year-old man with chronic obstructive pulmonary disease (COPD), rheumatoid arthritis, and chronic bilateral hydropneumothoraces, who developed pyopneumothorax due to dual infections with and . The patient presented with worsening dyspnea, hypoxemia, and respiratory acidosis, requiring hospitalization and chest tube thoracostomy. Cultures from purulent pleural fluid identified and , necessitating a multidisciplinary approach involving antimicrobials, infectious disease consultation, and pulmonary care. Despite initial improvement, the patient experienced recurrent pyopneumothorax, highlighting challenges in managing complex polymicrobial pleuropulmonary infections. This case underscores the importance of considering rare pathogens in empyema, particularly in patients with chronic pleuropulmonary conditions, and emphasizes the need for close follow-up and tailored therapeutic strategies to optimize outcomes.
脓胸是一种胸腔积液，其特征是胸腔内积聚脓液，最常见的原因是细菌感染，通常是肺炎的并发症。本病例报告介绍了一名70岁男性，患有慢性阻塞性肺疾病（COPD）、类风湿性关节炎和慢性双侧血气胸，因感染[具体细菌名称1]和[具体细菌名称2]而发展为脓气胸。患者出现呼吸困难加重、低氧血症和呼吸性酸中毒，需要住院治疗并进行胸腔闭式引流术。脓性胸腔积液培养鉴定出[具体细菌名称1]和[具体细菌名称2]，需要采取多学科方法，包括使用抗菌药物、咨询传染病专家和进行肺部护理。尽管最初有所改善，但患者仍反复出现脓气胸，凸显了管理复杂的多微生物胸膜肺部感染的挑战。该病例强调了在脓胸患者中考虑罕见病原体的重要性，特别是在患有慢性胸膜肺部疾病的患者中，并强调需要密切随访和制定个性化治疗策略以优化治疗效果。
