Abstract
Severe invasive streptococcal infection is associated with a sudden onset and rapid multiple organ dysfunction syndrome. We report a case of severe invasive streptococcal infection and acute empyema that developed in a patient with pneumonia caused by Streptococcal pyogenes infection. A 27-year-old healthy woman experienced symptoms of a common cold several days before the onset of the symptom. Acute pharyngitis was diagnosed during the day, and the patient was unexpectedly hospitalized for acute pneumonia in the evening of the same day. On the next day, she was referred to our critical care center because of rapid multiple organ dysfunction syndrome. Clinical manifestations and examination indicated severe invasive streptococcal infection, and treatment was administered. Thereafter, the patient's general condition improved, but she showed marked pleural effusion due to acute empyema. Although the pleural space was drained, acute empyema did not improve. Therefore, we performed thoracoscopic surgery on day 19. Postoperatively, the lung function remained below the normal limits because of pleural thickening, but gradually improved. The patient was discharged on day 35. It is necessary to consider the early treatment of acute empyema.
