Capnocytophaga pleural empyema following laparoscopic Nissen fundoplication. A rare complication, a rare pathogen.
Empyema complicating laparoscopic fundoplication is exceedingly rare, as is Capnocytophaga infection in the immunocompetent host, with the exception of gingivitis. We report a 29-year-old healthy man who presented with Capnocytophaga empyema 10 days after uneventful elective, laparoscopic Nissen fundoplication for gastroesophageal reflux disease. The exact mechanism of this complication is not known, but hypotheses, including a mini-Boerrhave's syndrome, can be drawn based on knowledge of the operation, the involvement of Capnocytophaga sp., and a patient history that included severe gingivitis. Because of prompt operative evacuation of the empyema and expedient identification of Capnocytophaga in the empyema fluid, appropriate antibiotic therapy was initiated. The infection was adequately treated, and the patient recovered fully. To the best of our knowledge, this is the first report of such a complication.
Hourmont
K
K
Department of General Surgery, University Hospital of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. khourmont@yahoo.com
Klingler
P J
PJ
Wetscher
G
G
Kafka
R
R
Gadenstätter
M
M
Bonatti
H
H
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002206:Capnocytophaga / Q000302:isolation & purification*; D016724:Empyema, Pleural / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D018662:Fundoplication / Q000009:adverse effects* / Q000379:methods; D005764:Gastroesophageal Reflux / Q000601:surgery; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents