AI Article Synopsis
- Acute empyema, a serious lung infection, has a high mortality rate of 10-25% despite treatments like antibiotics and chest tube drainage; this case involved a rare instance caused by Aeromonas hydrophila.
- A 76-year-old man with liver cirrhosis was admitted with suspected acute empyema, but he died shortly after receiving treatment, with A. hydrophila identified in postmortem cultures.
- A review of previous cases showed that most patients were male with similar liver issues, and while some survived, the overall prognosis remains concerning, highlighting the need for awareness among healthcare professionals.
Article Abstract
Introduction: Despite the advance in antibiotics and widespread chest tube drainage, acute empyema still shows a high mortality rate, accounting for 10-25%. We experienced a case of acute empyema caused by A. hydrophila, which is extremely uncommon, and reviewed all previously published articles.
Case Presentation: A 76-year older man with a medical history of liver cirrhosis (LC) due to chronic hepatitis C and hepatic cell carcinoma was admitted to our institute. Elevated inflammatory reaction and effusions on chest CT were seen, and he was suspected of having acute empyema. Although an empiric antibiotic therapy of meropenem with chest tube drainage was performed as an initial treatment, he died within 8 hours of admission. Postmortem, both blood and left pleural fluid cultures yielded Aeromonas hydrophila. The final diagnosis was acute empyema caused by A. hydrophila. We reviewed previously reported empyema caused by Aeromonas species cases (4 A. hydrophila, and 1 A. veronii) in 4 previous reports written in English, including ours. Of 5, all were male, and the mean age was 52 years (range 27-76 years). All patients had LC due to alcohol or viral infections. As for antibiotics initially prescribed, third-generation cephalosporins were most frequently used in 3/5 (60%). Thoracentesis was performed in all patients (100%). As for prognosis, 2 (40%) survived, and 3 (60%) died.
Conclusion: Physicians should be aware of the possibility of acute empyema caused by A. hydrophila among patients with chronic hepatic disease.
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| http://dx.doi.org/10.1016/j.jiac.2021.12.029 | DOI Listing |
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