Allergy Asthma Respir Dis.  2019 Jan;7(1):61-64. 10.4168/aard.2019.7.1.61.

Iatrogenic pleural empyema caused by Propionibacterium acnes

• Jwa H
• Lee J
• Seong GM
• Kim C

• KMID: 2434132
• DOI: http://doi.org/10.4168/aard.2019.7.1.61

Abstract

Propionibacterium acnes is one of the commensals living on the human skin and glands, implicated mainly in acnes, but seldom in deep infection. Pleural empyema is rarely complicated with closed thoracostomy. We experienced 1 case of empyema caused by P. acnes after pleural biopsy and closed thoracostomy through a percutaneous pigtail catheter. A 79-year-old man was admitted for cough, purulent sputum and shortness of breath. Three weeks ago, closed thoracostomy and pleural biopsy were performed to confirm a diagnosis for his recurrent pleural effusion. He had increased amount of right pleural effusion. Through the pigtail catheter, pleural effusion was removed. Gram-positive rods were observed in Gram stain, but not cultured. By 16S rRNA analysis, P. acnes was confirmed as the pathogen. His empyema was repeatedly treated with antibiotics, fibrolysis and irrigation. Pleural decortication was recommended. We report the first case of empyema with P. acnes in Korea, possibly complicated with closed thoracostomy procedures.

Keyword

Pleural empyema; Thoracotomy; Propionibacterium acnes; Pleural effusion

MeSH Terms

Aged
Anti-Bacterial Agents
Biopsy
Catheters
Cough
Diagnosis
Dyspnea
Empyema
Empyema, Pleural*
Gram-Positive Rods
Humans
Korea
Pleural Effusion
Propionibacterium acnes*
Propionibacterium*
Skin
Sputum
Thoracostomy
Thoracotomy
Anti-Bacterial Agents

Figure

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  Fig. 1 (A) Chest radiograph showing right hydropneumothorax at admission. (B) Right pleural effusion was improved after pigtail catheter insertion.

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  Fig. 2 Phylogenetic relationships of representative isolates and related type strains from 16S rRNA gene sequences.

• 

  Fig. 3 Gross characteristics of the drained fluid.

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