A SIZEABLE COMPLICATION OF UNTREATED PNEUMONIA: A VIRIDANS STREPTOCOCCI POST PNEUMONIC EMPYEMA THORACIS

TOPIC: Lung Pathology TYPE: Medical Student/Resident Case Reports INTRODUCTION: Community acquired pneumonia (CAP) can result in significant morbidity and mortality. Among the patients admitted with CAP, a rare complication is parapneumonic or post pneumonic empyema thoracis. Although course may vary patient to patient, these complications lead prolonged treatment thus leading longer hospital stay increased Early detection of CAP key avoiding fatal complications. CASE PRESENTATION: We describe 36 year-old-male past medical history asthma, tobacco heroin abuse who presented chief complaint shortness breath. The was previously two months prior he treated for an asthma exacerbation community pneumonia. Upon discharge, did not complete antibiotic prescribed. He also reportedly developed worsening dyspnea on exertion associated fever, chills, unintentional weight loss pleuritic chest pain. Due his dyspnea, subsequently returned seek emergency treatment. On this presentation, CT ordered demonstrated 17 x 15 23.5 cm cystic structure. Along this, right middle lower lobe collapse leftward mediastinal shift were noted. surgery consulted underwent thoracoscopy that converted thoracotomy, pulmonary decortication, parietal pleurectomy eventual tube placement. Per operative report, three liters purulent foul smelling material drained from lung during procedure. sent cultures grew pan-sensitive Streptococcus intermedius. then antibiotics discharged home close follow-up. DISCUSSION: Pneumonia cause thoracis, therefore, it important recognize serious complication. intervention crucial as mortality significantly rises are without A subset require urgent exploratory thoracotomy within 24 48 hour indications including: parenchymal, multiple loculations trapped lung. CONCLUSIONS: thoracis does have any age preference, typically more common elderly population comorbidities. Interestingly, our younger than expected range resulted early termination therapy. REFERENCE #1: Garvia V, Paul M. Empyema. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459237/ DISCLOSURES: No relevant relationships by Sara Khalid, source=Web Response Mahnoor Khan, Robert Ondracek,