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Ryu, Lee, Lee, Kim, Yang, Ryu, Yu, Cheong, and Chae: A Case of Empyema Caused by Streptococcus Constellatus
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 66(6): 463-466.

Published online: 30 June 2009

DOI: https://doi.org/10.4046/trd.2009.66.6.463

A Case of Empyema Caused by Streptococcus Constellatus

Yong Suc Ryu, M.D.1, Jae Hyung Lee, M.D.1, Byung Hoon Lee, M.D.1, Sang Hoon Kim, M.D.1, Dong Jin Yang, M.D.1, Sang Ryol Ryu, M.D.1, Yun Hwa Yu, M.D.1, Mi Youn Cheong, M.D.1, Jeong Don Chae, M.D.2

1Department of Internal Medicine, Eulji Hospital, Eulji University College of Medicine, Seoul, Korea.

2Department of Laboratory Medicine, Eulji Hospital, Eulji University College of Medicine, Seoul, Korea.

Address for correspondence: Byung Hoon Lee, M.D. Division of Pulmonology, Department of Internal Medicine, Eulji University College of Medicine, Eulji General Hospital, 281-1, Hagye-dong, Nowon-gu, Seoul 137-711, Korea. Phone: 82-2-970-8625, Fax: 82-2-970-8621, hoonakr@eulji.ac.kr

Received 7 May 2009       Accepted 8 June 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Streptococcus constellatus (S. constellatus) is a commensal microorganism belonging to the "Streptococcus milleri" group, but may cause infections in different locations in immunocompromised patients. The infection of S. constellatus has high mortality and morbidity due to its tendency to cause abscesses in infected patients, which require immediate surgical drainage for effective treatment. We report on a 72-year-old woman with end stage renal disease, who suffered from dyspnea and general weakness that had developed over 7 days. Chest CT showed loculated pleural effusion. S. constellatus was cultured from exudative pleural effusions and confirmed by an analysis of 16S rRNA sequence. The patient was treated with drainage of pleural effusion and piperacillin/tazobactam for 5 weeks.

Keywords: Streptococcus constellatus, Streptococcus milleri group, Empyema

Figures and Tables

Figure 1
Chest PA. (A) Chest PA on admission shows multiloculated pleural effusions and collapsed lung in right lower lung field. (B) Pleural effusion is markedly improved after 2 months treatment.
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Figure 2
Chest CT on admission Large multiloculated pleural empyema with numerous air bubble is shown in right pleural space.
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