tailieunhanh - báo cáo khoa học: "Aggregatibacter aphrophilus in a patient with recurrent empyema: a case report "

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Aggregatibacter aphrophilus in a patient with recurrent empyema: a case report | Ratnayake et al. Journal of Medical Case Reports 2011 5 448 http content 5 1 448 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Aggregatibacter aphrophilus in a patient with recurrent empyema a case report Lasantha Ratnayake1 William J Olver1 and Tom Fardon2 Abstract Introduction Aggregatibacter aphrophilus formerly Haemophilus aphrophilus and H. paraphrophilus is classically associated with infective endocarditis. Other infections reported in the literature include brain abscess bone and joint infections and endophthalmitis. There are only two cases of empyema ever reported due to this organism. We report the isolation of A. aphrophilus from pleural fluid on three separate hospital admissions in a patient with recurrent empyema. Case presentation A 65-year-old female patient of Caucasian origin presented with a three-week history of fever shortness of breath and dry cough. She was found to have a pleural empyema so a chest drain was inserted and a sample of pus was sent to the microbiology laboratory. After overnight incubation a chocolate blood agar plate incubated in 5 carbon dioxide showed a profuse growth of small round glistening colonies which were identified as Gram-negative coccobacilli. They were oxidase- and catalase-negative. Biochemical testing using RapID NH confirmed the identity of the organism as A. aphrophilus. It was susceptible to amoxicillin levofloxacin and doxycycline. Our patient was treated with intravenous amoxicillin with clavulanic acid and clarithromycin followed by oral doxycycline but was re-admitted twice over the next three months with recurrent empyema and the same organism was isolated. Each episode was managed with chest drainage and a six-week course of antibiotic doxycycline for the second episode and amoxicillin for the third episode after which she has remained well. Conclusion This is the first case report of recurrent empyema due to A. aphrophilus. Our patient had no underlying condition