2018 Volume 32 Issue 5 Pages 600-605
Streptococcus pyogenes is a well-known pathogenic bacteria causing lethal necrotizing fasciitis. There have been few reports about acute pleural empyema. We retrospectively reviewed 2 cases of acute pleural empyema caused by Streptococcus pyogenes with reference to the literature. Case 1: A 36-year-old woman with no medical history of note. Chief complaints were vomiting and diarrhea. Right pleural effusion was detected on a chest radiograph. Streptococcus pyogenes was identified from her pleural effusion and blood culture. She was admitted to our hospital, and we performed thoracoscopic debridement and drainage for pleural empyema and mediastinitis. She was discharged on the 24th day after surgery without any complications. Case 2: A 32-year-old woman with a medical history of uterine myoma. She developed bacterial enteritis and was treated with antibiotics. Streptococcus pyogenes was identified from her blood culture. Right pleural effusion was noted on a chest radiograph. After admission to our hospital, we performed thoracoscopic debridement and drainage. She was discharged on the 22nd day after surgery without any complications. Both cases subsequently developed acute pleural empyema after abdominal symptoms. We emergently performed thoracoscopic debridement and irrigation. We could control their pleural empyema and achieve good results. Infection caused by Streptococcus pyogenes may lead to severe pleural empyema, and so early surgical intervention using thoracoscopy may be critical.
