title: Pneumonia and Pleural Empyema due to a MixedLactobacillusspp. Infection as a Possible Early Esophageal Carcinoma Signature.
abstract: Lactobacilli are human commensals found in the gastrointestinal and genitourinary tract. Although generally conceived as non-pathogenic microorganisms, the existence of several reports implicating them in certain severe pathological entities renders this species as opportunistic pathogens. The case of a 58-year-old woman with mixedLactobacillusinfection is described. The patient was admitted in an outpatient clinic with community acquired pneumonia, and on the third day of hospitalization she presented rapid pneumonia deterioration. Subsequent imaging techniques revealed increased pleural empyema in alignment with the general deterioration of her clinical condition. Pleural fluid culture revealed the presence ofLactobacillus delbrueckiiandLactobacillus gasseriand the infection was successfully treated with clindamycin. Five months after hospital discharge and an overall good condition, the patient developed signs of dysphagia and upon re-admission an inoperable esophageal carcinoma was diagnosed. The patient succumbed to the cancer 11 months later. Herein, we report for the first time a mixed respiratory infection due to lactobacilli, possibly associated with a formerly unveiled esophageal malignancy.
authors.affiliation: Pulmonary Department, Corfu General Hospital , Corfu , Greece.
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Chaini
authors.affiliation: Pulmonary Department, Athens Medical Center - Peristeri , Peristeri , Greece.
authors.forename: Nikolaos D
authors.initials: ND
authors.lastname: Chainis
authors.affiliation: Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece; Department of Biopathology and Clinical Microbiology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Ioannidis
authors.affiliation: Department of Biopathology and Clinical Microbiology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Magana
authors.affiliation: Department of Biopathology and Clinical Microbiology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece.
authors.forename: Chryssoula
authors.initials: C
authors.lastname: Nikolaou
authors.affiliation: Department of Microbiology, Medical School, National and Kapodistrian University of Athens , Athens , Greece.
authors.forename: Joseph
authors.initials: J
authors.lastname: Papaparaskevas
authors.affiliation: Department of Biopathology and Clinical Microbiology, Athens Medical Center - Peristeri , Peristeri , Greece.
authors.forename: Melina-Vassiliki
authors.initials: MV
authors.lastname: Liakata
authors.affiliation: Department of Pathology, Athens Medical Center - Peristeri , Peristeri , Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Katopodis
authors.affiliation: Department of Cardiac Surgery, Athens Medical Center , Athens , Greece.
authors.forename: Leonidas
authors.initials: L
authors.lastname: Papastavrou
authors.affiliation: Torrey Pines Institute for Molecular Studies, Port St. Lucie, FL, USA; Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA; Department of Dermatology, Harvard Medical School, Boston, MA, USA.
authors.forename: George P
authors.initials: GP
authors.lastname: Tegos
authors.affiliation: Department of Biopathology and Clinical Microbiology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece.
authors.forename: Stylianos
authors.initials: S
authors.lastname: Chatzipanagiotou
keywords: Lactobacillus delbrueckii; Lactobacillus gasseri; bacterial translocation; esophageal carcinoma; pleural empyema; pneumonia