Poster Session : PS 0396 ; Infectious Disease ; A Rarely Seen Empyema Cause: Leuconostoc Mesenteroides = Poster Session : PS 0396 ; Infectious Disease ; A Rarely Seen Empyema Cause: Leuconostoc Mesenteroides

다국어 초록 (Multilingual Abstract)

Case report: 64 year-old male patient was presented with cough, fever and sputum production. His medical history was unremarkable. He was producing and selling pickled vegetables. Only pathological fi nding in his physical examination was the reduction of pulmonary sounds in the lower part of left lung. Hemogram showed; leukocyte:5500/mm³ (neutrophil 65%, lymphocyte 30%), platelet: 287000/mm³, hematocrit 28%. Biochemical tests revealed normal, serum CRP level was 11,7 mg/dl. Pleural effusion was present in chest X-ray. Pleural ponction was performed. Gram-positive cocci and high concentration of leukocytes were seen in gram-staining in the exudative pleural fi uid. In the culture Leuconostoc mesenteroides was grown. CT showed pleural effusion and a consolidation containing air bronchogram. The patient was diagnosed with pleural empyema and drainage treatment with thorax tube and 2 grams of ceftriakson and 1 gr claritromycin daily were started. The symptoms regressed beginning from the fourth day. On the fourteenth day, CRP level returned to normal. The treatment was stopped at twenty-fi rst day with full recovery. Discussion: Leuconostocs are members of the family Streptococcacae and have only recently been recognized as potential pathogens. Infections by Leuconostoc species bacteria are uncommon, and usually affect patients with an underlying disease, or those fi tted with a venous catheter or subjects previously treated with vancomycin. Bacterias are found naturally in plants and vegetables and are used in milk, pickle and wine industries. While an underlying factor is needed for those organisms to become pathogenic, our case was completely healthy and had no invasive procedure previously. Because he was selling and directly producing pickles, it was considered that the organism could have passed directly. This case points out that; Leuconostoc mesenteroides should be considered as a causative agent in nasocomial infections, also in non- immunocompromised patients.