title: Pleural Enterococcus faecalis empyema: an unusual case.
abstract: A 63-year-old female patient was admitted to the department of neurology following an acute ischemic infarction of the right medial cerebral artery. She developed fever, respiratory failure, and hypotension and had to be transferred to the intensive care unit (ICU) for intubation and mechanical ventilation. Chest X-ray showed increased density of the complete right hemi-thorax, indicative of massive pleural effusion. Chest tube drainage produced 1.5 l of pus in 1 h. Cultures revealed growth of Enterococcus faecalis. The patient was treated with amoxicillin and clavulanic acid with good clinical response. Enterococci very rarely cause spontaneous pleural empyema. The natural resistance of enterococci to several types of antibiotics can lead to selection of enterococci as seen in other clinical studies and may lead to this unusual clinical consequence.
authors.affiliation: Department of Intensive Care, Gelderse Vallei Hospital, 9025, 6716 RP, Ede, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Bergman
authors.forename: D H T
authors.initials: DH
authors.lastname: Tjan
authors.forename: M A
authors.initials: MA
authors.lastname: Schouten
authors.forename: L E M
authors.initials: LE
authors.lastname: Haas
authors.forename: A R H
authors.initials: AR
authors.lastname: van Zanten
mesh_terms: D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002544:Cerebral Infarction / Q000150:complications; D004653:Empyema / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D013293:Enterococcus faecalis / Q000302:isolation & purification*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D013902:Radiography, Thoracic
chemical_list: D000900:Anti-Bacterial Agents; D019980:Amoxicillin-Potassium Clavulanate Combination