Spontaneous Enterococus Faecalis Empyema in a Patient With Covid-19

Abstract

Since its discovery severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people worldwide causing the current coronavirus disease 2019 (Covid-19) pandemic. Presenting symptoms range from asymptomatic to mild disease to respiratory failure and death. Some patients develop a cytokine release like syndrome which manifests with increased markers of inflammation and is associated with acute respiratory distress syndrome (ARDS), multiorgan failure, and death. Treatment with immunomodulatory agents have been proposed to attenuate disease severity and mortality. However, literature is conflicting whether widespread immunosuppression is beneficial or detrimental (1,2). We report a case of a patient diagnosed with Covid-19 induced ARDS requiring extracorporeal membrane oxygenation (ECMO), initially treated with the interleukin-6 (IL-6) antagonist, tocilizumab, who later developed enteroccocus faecalis empyema. No relevant relationships by Mangalore Amith Shenoy, source¼Web Response No relevant relationships by Alexandra Zavin, source¼Web Response

Tracheo‐esophageal fistula and pleural empyema in the course of SARS‐CoV‐2 infection—A case report

“…In the first stage of a pleural empyema, the optimal treatment may be appropriate antibiotic therapy and pleural drainage. 8 This approach in the treatment of a pleural empyema in the course of SARS‐CoV‐2 infection has proven effective in the patients described by Zavin et al and Silalahi et al 17 , 18 …”

“…In the first stage of a pleural empyema, the optimal treatment may be appropriate antibiotic therapy and pleural drainage. 8 This approach in the treatment of a pleural empyema in the course of SARS-CoV-2 infection has proven effective in the patients described by Zavin et al and Silalahi et al 17,18 Regarding the surgical approach, video-assisted thoracic surgery (VATS) is considered the "gold standard for the surgical management of an empyema." 19 VATS enables the proper decortication of an empyema as effectively as thoracotomy, and is associated with less pain and, at the same time, greater patient acceptance.…”

Culture-negative pleural empyema after Coronavirus disease-19 resolution – A case report

“…Those aged 60 years old or above and with severe diseases are the main risk factors [ 4 ]. Unilateral exudative effusion with high LDH and fluid-serum LDH ratio is predominant in such patients [ [3] , [4] , [5] , [6] ].…”

“…He had also been hospitalized earlier for quinolones; hence non-growth pleural fluid culture was highly probable. In this case, if readily available, bacterial PCR would have been useful to confirm bacterial presence [ 5 ].…”