[Pleural empyema due to Salmonella typhi].
65 years old female was admitted to hospital with fever, purulent sputum and dyspnea. The patient has hepatic cirrhosis secondary to autoimmune hepatitis and hepatocellular carcinoma. Immunosuppressive treatment is used for autoimmune hepatitis. In physical examination matute and diminished respiratory sounds were determined at right hemithorax. Ascitis was determined in abdominal examination. Chest X-ray showed pleural effusion in right hemithorax. Serohemorrhagic fluid was aspirated by thoraco-synthesis. Pleural fluid pH was 6.9 and had an exudative nature. The patient was the diagnosed as empyema. Right tube thoracostomy was performed and sulbactam-ampicillin 6 g/day therapy was started. In patient's ascite fluid no bacteria and leucocytes was seen. Salmonella typhi was isolated from pleural fluid. No microorganisms were isolated from ascite fluid, urine and stool culture. Klebsiella pneumoniae is isolated in patient's hemoculture. Clinical improving was detected. Chest X-ray showed total regression of pleural fluid and the tube thoracostomy removed. We presented this case because of rarely seen microorganism (S. typhi) in immunocompromised patients a cause of pleural empyema which is frequently seen gastrointestinal infections.
Kömüs
Nuray
N
Department of Chest Disease, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey. nkomus@yahoo.com
Kilinç
Oğuz
O
Güneş
Jini
J
Soytürk
Müjde
M
D000368:Aged; D016724:Empyema, Pleural / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D013902:Radiography, Thoracic; D012485:Salmonella typhi / Q000302:isolation & purification*; D014435:Typhoid Fever / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging