A rare case of streptomyces pulmonary infection with bronchopleural fistula

Abstract

We report a rare fatal case of Streptomyces spp. intrathoracic infection causing a bronchopleural fistula in a 71-year-old man on long-term prednisone. A VATS decortication was performed, revealing a large pus-filled cavity. Histological examination of lung tissue revealed numerous sulfur granules with characteristic macroscopic and microscopic morphology. Branching Gram positive rods were seen on direct Gram stain. Cultures grew Streptomycyes spp. which was identified by MADI-TOF mass spectrometry and typical cultural and staining characteristics. Streptomyces genus identification was confirmed by 16S-rRNA and secA gene sequencing.