Sphingomonas paucimobilis empyema caused by remote foreign body aspiration

BMJ Case Rep. 2018 Apr 11:2018:bcr2017223591. doi: 10.1136/bcr-2017-223591.

Abstract

Empyema secondary to foreign body aspiration is rare in adults. We present a case of empyema in a 77-year-old male patient related to a remote aspiration event during a dental procedure. A CT of the chest and bronchoscopy confirmed that a metallic foreign body was located within the right lower lobe bronchus. His pleural fluid culture revealed Sphingomonas paucimobilis which is a low-virulent opportunistic gram-negative bacilli and rarely causes infection. The patient received meropenem followed by levofloxacin and recovered uneventfully. The attempt of foreign body removal was failed due to chronic inflammation, and the patient refused further surgical management.

Keywords: infectious diseases; respiratory medicine.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Bronchoscopy
  • Empyema, Pleural / etiology
  • Foreign Bodies / diagnostic imaging*
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / drug therapy*
  • Humans
  • Levofloxacin / administration & dosage*
  • Lung / diagnostic imaging
  • Lung / pathology
  • Male
  • Meropenem
  • Respiratory Aspiration
  • Sphingomonas* / isolation & purification
  • Thienamycins / administration & dosage*
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents
  • Thienamycins
  • Levofloxacin
  • Meropenem