Polymicrobial empyema; a novel case of Actinomyces turicensis

Abstract

Empyema or infection of the pleural space is a well described complication of pneumonia, however knowledge of culprit pathogens is still evolving. We report a novel case of empyema due to Actinomyces turicensis , a commensal of the oropharynx and female urogenital tract but previously undescribed cause of empyema . We additionally review general pathogenesis of Actinomyces species within the pleural space. Familiarity with this unique pleural infection pathogen is important for selection of adequate antimicrobial therapy given the propensity of anaerobes such as Actinomyces species to disobey anatomic boundaries and recrudescence of infection in the absence of appropriate therapy.

A Unique Case of Conservatively Treated Actinomyces Empyema Complicated Due to Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome

“…Advanced age, diabetes, alcohol abuse, chronic respiratory disorders, and poor dental hygiene are important factors that predispose individuals to the disease. A patient suffering from pulmonary actinomycosis typically presents with weight loss, productive cough, chest pain, and consolidation or mass-like lesion, which engender a broad differential including lung cancer and other chronic suppurative lung infections such as fungal infections, lung abscesses, and tuberculosis [ 7 , 8 ]. If left unchecked the infection may invade the pleura and result in actinomyces empyema, an extremely uncommon condition particularly when Actinomyces meyeri is the underlying cause.…”