title: Pyopneumothorax secondary to Streptococcus milleri infection.
abstract: We report a case of a 46-year-old Malay woman with underlying hypothyroidism post thyroidectomy who presented with worsening breathlessness, orthopnoea, productive cough and left-sided pleuritic chest pain of 3 days duration. Chest X-ray on admission showed left-sided massive hydropneumothorax. Pleural tapping revealed empyema. A chest tube was inserted immediately. The culture of pleural fluid grew Streptococcus constellatus The patient was treated with antibiotics for a total of 6 weeks and underwent open thoracotomy and decortication during admission. Subsequently, her lung condition improved and there was no evidence of recurrence during follow-up.
authors.affiliation: Department of Medical, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
authors.forename: Mohd Jazman
authors.initials: MJ
authors.lastname: Che Rahim
authors.affiliation: Department of Internal Medicine, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
authors.forename: Nurashikin
authors.identifier: http://orcid.org/0000-0003-2178-6121
authors.initials: N
authors.lastname: Mohammad
authors.affiliation: Department of Internal Medicine, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
authors.forename: Wan Syamimee
authors.initials: WS
authors.lastname: Wan Ghazali
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015505:Chest Tubes; D003937:Diagnosis, Differential; D016724:Empyema, Pleural / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D005260:Female; D006801:Humans; D006872:Hydropneumothorax / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D008875:Middle Aged; D013290:Streptococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D034364:Streptococcus milleri Group; D013908:Thoracotomy; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents