trimethoprim--sulfamethoxazole-drug-combination and Empyema--Pleural

We describe a case of pneumonia and empyema thoracis caused by trimethoprim-sulfamethoxazole-susceptible, but imipenem-resistant Nocardia abscessus in a cancer patient. The isolate was confirmed to the species level by 16S rRNA sequencing analysis. The patient did not respond to antibiotic therapy, including ceftriaxone and imipenem, and died of progressing pneumonia and multiple organ failure.

Topics: Anti-Bacterial Agents; Ceftriaxone; Drug Resistance, Multiple, Bacterial; Empyema, Pleural; Hemangiosarcoma; Humans; Imipenem; Immunocompromised Host; Male; Middle Aged; Multiple Organ Failure; Nocardia; Nocardia Infections; Pneumonia; RNA, Ribosomal, 16S; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Aged; Anti-Infective Agents; Empyema, Pleural; Humans; Male; Sweet Syndrome; Trimethoprim, Sulfamethoxazole Drug Combination

We report a 45-year-old woman of systemic lupus erythematosus (SLE) with thoracic empyema that was unusually infected by Mycobacterium tuberculosis (MTB), Nontuberculosis mycobacteria (NTM) concomitant with Nocardia asteroides. After a combined treatment of cotrimoxazole, clarithromycin and anti-tuberculosis drugs with a short-term of intravenous immunoglobulin (IVIG), the patient recovered from the critical illness. On the basis of the results in this case, we recommend a thorough survey of the probably concomitant infections of MTB and NTM in an immunocompromised patient with a known N. asteroid infection. In addition, an adjuvant intravenous immunoglobulin therapy may have beneficial effect in the control of infections in an SLE patient.

Topics: Antitubercular Agents; Clarithromycin; Drug Therapy, Combination; Empyema, Pleural; Empyema, Tuberculous; Female; Humans; Immunocompromised Host; Immunoglobulins, Intravenous; Lupus Erythematosus, Systemic; Middle Aged; Mycobacterium; Nocardia asteroides; Taiwan; Trimethoprim, Sulfamethoxazole Drug Combination

Listeriosis in HIV infected patients is uncommon and usually presents as meningitis or bacteraemia. Pleural fluid infections caused by this organism are extremely rare. A case is described of empyema caused by Listeria monocytogenes in an HIV infected patient that was successfully treated with medical treatment only.

Topics: Adult; Ampicillin; Anti-Infective Agents; Drug Therapy, Combination; Empyema, Pleural; Female; Gentamicins; HIV Infections; Humans; Listeriosis; Trimethoprim, Sulfamethoxazole Drug Combination

We report a case of 25 year old man who presented with a febrile illness and bilateral lower chest pain a pain in the left hypochondrium with fever and weight loss; investigations revealed a left sided empyema. The cause of the empyema was confirmed following the isolation in the pleural pus of Salmonella typhi. There was also a mass in the left hypochondrium which was shown on ultrasound to be a splenic abscess. After antibiotic therapy with Cotrimoxazole, repeated pleural aspirates and physiotherapy, there was a satisfactory outcome and the pleural effusion dried up and there was a significant reduction in the volume of the splenic abscess. In the light of their observations, the authors report the rare presentation of empyemas due to Salmonella typhi, the late presentation during the course of the third septenaire and the often favourable outcome under general antibiotic therapy associated with pleural aspirates to evacuate the pus and respiratory physiotherapy.

Topics: Abscess; Adult; Anti-Bacterial Agents; Empyema, Pleural; Humans; Male; Respiratory Therapy; Salmonella typhi; Splenic Diseases; Suction; Trimethoprim, Sulfamethoxazole Drug Combination; Typhoid Fever