Empyema Thoracis Caused by Klebsiella Spp and Escherichia coli Co-Infection - An Uncommon Isolation with Atypical Presentation
Maryam Shehu *
Department of Paediatrics, College of Medicine and Health Sciences, Bingham University/Teaching Hospital, Jos, Plateau State, Nigeria.
Hassan Shehu
Department of Surgery, College of Medicine and Health Sciences, Bingham University/Teaching Hospital, Jos, Plateau State, Nigeria.
Judith Bebeyi
Department of Paediatrics, Bingham University Teaching Hospital, Jos, Plateau State, Nigeria.
Edwin Oseni-Momodu
Department of Surgery, College of Medicine and Health Sciences, Bingham University/Teaching Hospital, Jos, Plateau State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Empyema thoracis is the collection of pus in the pleural space. A 9-year-old boy presented with a 3-day history of high grade continuous fever, a day history of abdominal pain, distension and fast breathing. Examination findings: acutely ill child, febrile, in respiratory distress. Chest findings: tachypnea, dull percussion note and decreased air entry on the right hemithorax. Chest radiograph: massive fluid collection in the right hemithorax. A pleural tap yielded frank pus that was sent for microscopy, culture and sensitivity (MCS). Escherichia coli was cultured which was sensitive to fluoroquinolones. Klebsiella spp was also cultured from the blood sample taken for MCS and yielded the same sensitivity. Patient responded well to tube thoracostomy drainage and administration of antibiotics. Empyema thoracis with the isolation of two-gram negative organisms in a previously healthy child is rare.
Keywords: Empyema thoracis, klebsiella specie, Escherichia coli