Abstract
EMPYEMA caused by<i>Clostridium perfringens</i>is a rare infection that usually can be cured by penicillin therapy and drainage.<sup>1,2</sup>We describe a patient with clostridial empyema that was unusual because the organism was unresponsive to penicillin therapy. <h3>Report of a Case</h3> A 49-year-old man with severe peripheral arterial disease of the legs was admitted because of heart failure due to alcoholrelated congestive cardiomyopathy. Pulses were not palpable in his right leg, and a 2×3-cm ulcer was present on his right foot. Initial chest roentgenogram showed cardiomegaly and pulmonary edema. Although his condition improved on digoxin, furosemide, and hydralazine hydrochloride, he experienced a temperature of 37.7 °C and mild mental confusion. His WBC count was 22,000/cu mm, with a differential cell count of 90% polymorphonuclear leukocytes and 2% band cells. Lumbar puncture studies gave normal results. A chest roentgenogram on the seventh hospital day showed a loculated right pleural effusion.
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