Successful treatment of acute empyema caused by Aeromonas sobria in an advanced liver cirrhosis patient: A case report

  • Trinh Van Son 108 Military Central Hospital
  • Vuong Phuc Duong 108 Military Central Hospital
  • Quyen Dang Tuyen 108 Military Central Hospital
  • Nguyen Thi Thuy 108 Military Central Hospital
  • Nghiem Xuan Hoan Vietnamese-German Center for Medical Research

Main Article Content

Keywords

Liver cirrhosis, Aeromonas sobria, pleural empyema

Abstract

Bacterial empyema is a rare complication of liver cirrhosis (LC) patients. The treatment of patients was challenge and associated with poor outcome. Case report: In this article, we reported for the first time a 55-year-old patient with decompensated LC due to alcohol abuse who was diagnosed with acute empyema. Bacterial culture of pleural fluid indicated Aeromonas sobria (A. sobria) as a causative pathogen. The patient also performed severe coagulation disorder with INR 2.56; platelet counts 24G/L. The patient was successfully managed by board-spectrum antibiotics and drainage of the pleural with pigtail catheter. He was followed for a year without relapsing. Conclusion: We reported the first case of severely acute empyema caused by A. sobria in a patient with decompensated LC and successful treatment with appropriate antibiotics in combination with pigtail drainage in our clinical setting.

Article Details

References

1. Sepanlou SG, Safiri S, Bisignano C et al (2020) The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2013;2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet Gastroenterology & Hepatology 5(3): 245-266.
2. Bartoletti M, Giannella M, Tedeschi S et al (2018) Opportunistic infections in end stage liver disease. Infect Dis Rep 10(1): 7621.
3. Spadaro S, Berselli A, Marangoni E et al (2014) Aeromonas sobria necrotizing fasciitis and sepsis in an immunocompromised patient: A case report and review of the literature. J Med Case Rep 8: 315.
4. Shizuma T (2019) Aeromonas infections in patients with liver cirrhosis in Japan. Journal of Liver 08(2): 1-4.
5. Shen TC, Chen CH, Lai HC et al (2017) Risk of empyema in patients with chronic liver disease and cirrhosis: a nationwide, population-based cohort study. Liver International 37: 862-870.
6. Emhmed Ali S, Akanbi O, Godman M, Soliman M, Frandah WM, Benrajab K (2019) A challenging case of spontaneous bacterial empyema in a cirrhotic patient. J Community Hosp Intern Med Perspect 9(4): 322-324.
7. Shen KR, Bribriesco A, Crabtree T, Denlinger C, Eby J, Eiken P, Jones DR, Keshavjee S, Maldonado F, Paul S, Kozower B (2017) The American Association for Thoracic Surgery consensus guidelines for the management of empyema. J Thorac Cardiovasc Surg 153(6): 129-146.
8. Mayrhofer R, Menanteau-Ledouble S, Pucher J, Focken U, El-Matbouli M (2020) Aeromonas spp. suggested as the causative agents of red spot disease in northern Vietnamese grass carp Ctenopharyngodon idella. Dis Aquat Organ 139: 113-119.
9. Wang JT, Fang CT, Hsueh PR et al (2000) Spontaneous bacterial empyema caused by Aeromonas veronii biotype sobria. Diagn Microbiol Infect Dis 37(4): 271-273.
10. Chao CM, Gau SJ, and Lai CC (2012) Empyema caused by Aeromonas species in Taiwan. Am J Trop Med Hyg 87(5): 933-935.
11. Xiol X, Castellví JM, Guardiola J et al (1996) Spontaneous bacterial empyema in cirrhotic patients: a prospective study. Hepatology 23(4): 719-723.