title: Disseminated Streptococcus anginosus infection with empyema thoracis in a patient with sarcoma.
abstract: Streptococcus anginosus is a member of the normal flora of the oral cavity and a pathogen of thoracic infection. However, disseminated infection that was identified from different body fluids at the same time has never been reported. We report a 52-year-old man with advanced pulmonary sarcoma who developed neutropenia, bronchopleural fistula and thoracic empyema after chemotherapy. Viridans group Streptococcus was isolated from both empyema and urine, which was confirmed as S. anginosus according to the biochemical reaction profiles and 16S rRNA gene sequencing results. The patient recovered uneventfully after tube drainage and treatment with imipenem. Disseminated S. anginosus infection should be considered as a possible pathogen in immunocompromised patients with empyema and can be rapidly identified by 16S rRNA gene sequencing.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yu-Min
authors.initials: YM
authors.lastname: Chuang
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
authors.forename: Peilin
authors.initials: P
authors.lastname: Lee
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001483:Base Sequence / Q000235:genetics; D001859:Bone Neoplasms / Q000556:secondary*; D016724:Empyema, Pleural / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D016867:Immunocompromised Host; D008175:Lung Neoplasms / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D012336:RNA, Ribosomal, 16S / Q000648:ultrastructure; D011859:Radiography; D012509:Sarcoma / Q000473:pathology*; D012983:Soft Tissue Neoplasms / Q000473:pathology*; D034366:Streptococcus anginosus / Q000302:isolation & purification*; D013848:Thigh / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D012336:RNA, Ribosomal, 16S; D015378:Imipenem