Abstract
A previously healthy 31-year-old female was transferred to our hospital after laparoscopic drainage of an abdominal abscess. She was found to have a left-sided empyema, which grew Bacteroides fragilis on culture. She was then diagnosed with rectal adenocarcinoma that had perforated, accounting for the abdominal abscess. An unusual pathologic finding in the resected specimen was septic thrombi in the lumen of a small vein. To our knowledge, only six other cases of empyema associated with colorectal cancer have been reported since the 1960s. Aside from the cob-pleural fistula in two of those cases, the route of pleural infection in the reported cases was not totally clear. The finding of septic thrombi in a small vein in our case is good evidence that B. fragilis, a normal flora in the colorectum, may enter the circulation causing bacteremia and empyema. Therefore, unusual infections with fecal flora may indicate the presence of a malignancy.
Published Version
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