Empyema Caused by Streptococcus constellatus: Atypical Presentation of a Typical Pneumonia

Abstract

A 27-year-old man, with no known diseases, was admitted to our hospital with respiratory insufficiency and sepsis after 21 days of low-grade fever and non-productive cough without any other symptoms. He was diagnosed with fever of intermediate duration and doxycycline was initiated. An X-ray showed severe pleural effusion and a right lower lobe atelectasis. A pleural effusion sample study revealed an empyema, and an emergent thoracic tube was placed. Five days of empyema sample culture did not show pathological findings; thus, we performed a timeextended culture. After 8 days, Streptococcus constellatus was isolated. We completed 10 days of intravenous empiric treatment followed by oral cephalosporin. The patient required two thoracic drainages; there were no complications. He was completely asymptomatic 3 months after discharge. This report summarises the importance of oral microbiota as pathogens involved in community-acquired pneumonia among healthy young people and the atypical presentation of a typical complicated pneumonia.