[Empyema thoracis, hemorrhagic pericarditis and acalculous cholecystitis caused by Eikenella corrodens sepsis]

Orv Hetil. 2013 Nov 24;154(47):1873-6. doi: 10.1556/OH.2013.29752.
[Article in Hungarian]

Abstract

The authors present a case of a 29-year-old woman who was diagnosed with pneumonia in the left side complicated with pleural effusion and hemorrhagic pericarditis one month after she had undergone tonsillectomy. Eikenella corrodens was identified as pathogenic agent when the empyema was removed during thoracotomy. After the patient was given antibiotic treatment she was discharged from the hospital without any symptoms or complaints. However, one month after she had left the hospital she was readmitted to the surgical unit as an emergency because of acute abdominal complaints. On admission acalculous cholecystitis as well as hemorrhagic pericarditis requiring pericardiocentesis were also observed. A rare cause of sepsis, Eikenella corrodens was identified which resulted in a severe disorder including polyserositis. Pericardiocentesis was performed two times and the patient was given targeted antibiotics and non-steroidal anti-inflammatory drugs. She was also treated with antimycotics as she had developed mycosis. After one month the patient recovered and was discharged from the hospital. No further recurrence of symptoms or complaints was observed during follow up.

A szerzők 29 éves nőbetegük esetét ismertetik, akinél a garatmandulák sebészi eltávolítása után egy hónappal bal oldali empyemával szövődött tüdőgyulladás és pericarditis alakult ki. Kórokozóként Eikenella corrodenst azonosítottak a thoracotomiából végzett dekortikáció és empyemakiürítéssel nyert mellkasi folyadék tenyésztése során. A beteget célzott antibiotikus kezelést követően tünet- és panaszmentesen emittálták. Kórházi távozását követő egy hónap után heveny felhasi panaszokkal került sürgősséggel a sebészeti osztályra. Ekkor acalculosus cholecystitis mellett pericardialis punkciót igénylő haemorrhagiás pericarditist észleltek. A polyserositisszel járó kórképet a ritkán előforduló Eikenella corrodens okozta szepszissel magyarázták. A beteg két alkalommal végzett pericardiocentesis és célzott antibiotikus, nem szteroid gyulladáscsökkentő és mycosis kialakulása miatt antimycoticus kezelés mellett egy hónap után gyógyultan hagyta el az intézményt, és azóta is tünet- és panaszmentes. Orv. Hetil., 2013, 154(47), 1873–1876.

Keywords: Eikenella corrodens; acalculosus cholecystitis; acalculous cholecystitis; empyema; empyema thoracis; haemorrhagiás pericarditis; hemorrhagic pericarditis.

Publication types

  • Case Reports

MeSH terms

  • Acalculous Cholecystitis / diagnosis*
  • Acalculous Cholecystitis / microbiology*
  • Acalculous Cholecystitis / therapy
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / complications*
  • Bacteremia / diagnosis
  • Bacteremia / drug therapy
  • Bacteremia / microbiology
  • Drainage
  • Eikenella corrodens* / isolation & purification
  • Empyema, Pleural / diagnosis
  • Empyema, Pleural / microbiology*
  • Empyema, Pleural / therapy
  • Female
  • Gram-Negative Bacterial Infections / complications*
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / microbiology
  • Hemorrhage / etiology
  • Hemorrhage / therapy
  • Humans
  • Pericardiocentesis
  • Pericarditis / complications
  • Pericarditis / diagnosis
  • Pericarditis / microbiology*
  • Pericarditis / therapy
  • Thoracotomy
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents