Clinical Microbiology Perspective of Empyema caused by Streptococcus constellatus in Malignancy Patient: A Case Report
Downloads
Introduction: Streptococcus constellatus (SC) is commensal bacteria and belongs to Streptococcus anginosus group (SAG). However, SC causes infections especially in patient with underlying diseases. SC empyema is a clinical case that is described in very few studies, especially in Indonesia.
Case: A 45-year-old man was admitted to emergency department in Dr. Soetomo General Hospital Surabaya with respiratory insufficiency on November 11th 2020 after 3 months of non-productive cough and a week of weakness. He was diagnosed with empyema on right hemithorax and received chest tube insertion. SC was isolated from pleural fluid sample after first day of culture on Bactec BD bottle. GeneXpert result of pleural fluid was negative for Mycobacterium tuberculosis (MTB). He completed 10 days of intravenous ampicillin-sulbactam and metronidazole. The CT scan reported solid mass of 4.7x7.4x7.8 cm in posterolateral segment of inferior lobe right lung, right pleural effusion, with adenocarcinoma as biopsy result.
Discussion: SC is a normal commensal in respiratory tract, however with the presence of a certain factor such as immunocompromised, colonized SAG directly induces an infection after entering normal sterile sites in the body including pleural fluid.
Conclusion: Although infection caused by SC is a rare case, it still should be considered in clinical diagnosis and treatment of related infections, particularly in patients with comorbidities. The prognosis was good with appropriate antibiotics and chest tube insertion.
Noguchi S, Yatera K, Kawanami T, et al. The Clinical Features of Respiratory Infections Caused by the Streptococcus anginosus Group. BMC Pulm Med 2015; 15: 133.
Jiang S, Li M, Fu T, et al. Clinical Characteristics of Infections Caused by Streptococcus anginosus Group. Sci Rep 2020; 10: 9032.
Alejandro MH, Laura PP. Empyema Caused by Streptococcus constellatus : Atypical Presentation of a Typical Pneumonia. J Clin Case Reports 2018; 8: 1–2.
Vulisha AK, Sam R, Nur H, et al. Aggressive Presentation of Streptococcus constellatus. Cureus 2021; 13: e14534.
Kobo O, Nikola S, Geffen Y, et al. The Pyogenic Potential of the Different Streptococcus anginosus Group Bacterial Species: Retrospective Cohort Study. Epidemiol Infect 2017; 145: 3065–3069.
Parks T, Barrett L, Jones N. Invasive Streptococcal Disease: A Review for Clinicians. Br Med Bull 2015; 115: 77–89.
Asam D, Spellerberg B. Molecular Pathogenicity of Streptococcus anginosus. Mol Oral Microbiol 2014; 29: 145–155.
Hatrongjit R, Akeda Y, Hamada S, et al. Multiplex PCR for Identification of Six Clinically Relevant Streptococci. J Med Microbiol 2017; 66: 1590–1595.
Reis-Melo A, Soares D, Magalhí£es MF, et al. Complicated Pneumonia with Empyema Caused by Streptococcus Anginosus in a Child. Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo 2020; 38: e2018258.
Kanai E, Matsutani N. Management of Empyema: A Comprehensive Review. Curr Challenges Thorac Surgery; Vol 2 (November 2020) Curr Challenges Thorac Surg, https://ccts.amegroups.com/article/view/37410 (2020).
Garvia V, Paul M. Empyema. Treasure Island (FL), 2021.
Chrastek D, Hickman S, Sitaranjan D, et al. Streptococcus constellatus Causing Empyema and Sepsis, Necessitating Early Surgical Decortication. Case Reports in Infectious Diseases 2020; 2020: 4630809.
ObszaÅ„ska K, Kern-Zdanowicz I, KoziÅ„ska A, et al. Streptococcus anginosus (milleri) Group Strains Isolated in Poland (1996-2012) and Their Antibiotic Resistance Patterns. Polish J Microbiol 2016; 65: 33–41.
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions.
3. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution Share-Alike (CC BY-SA).
4. The Creative Commons Attribution Share-Alike (CC BY-SA) license allows re-distribution and re-use of a licensed work on the conditions that the creator is appropriately credited and that any derivative work is made available under "the same, similar or a compatible license”. Other than the conditions mentioned above, the editorial board is not responsible for copyright violation.