Open AccessThoracic empyema caused by P revotella spp. diagnosed using 16S rDNA sequence analysis
Author(s) -
Zhou Hua,
Shen Yihong,
Shen Qian,
Zhou Jianying
Publication year - 2015
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12106
Subject(s) - medicine , empyema , sputum , bronchoalveolar lavage , imipenem , gram staining , surgery , pleural fluid , metronidazole , chest pain , gastroenterology , lung , pathology , antibiotics , pleural effusion , tuberculosis , microbiology and biotechnology , antibiotic resistance , biology
We describe a case of thoracic empyema in a 76‐year‐old male with complication of diabetes mellitus and hypertension. His chief complaints were fever and chest pain. The patient was diagnosed as pleural infection according to the pulmonary computed tomography ( CT ) scan and laboratory results. The patient had persistent fever after the treatment of continuous percutaneous drainage and 1 week of intravenous moxifloxacin. He was then misdiagnosed as tuberculous pleuritis and still had fever after the treatment of 2 weeks' antituberculosis drugs. Repeated cultures of sputum, blood, bronchoalveolar lavage fluid and pleural fluid were all negative. A gram‐negative bacillus was found in the pleural pus G ram stain, and it was identified as P revotella spp. by 16S ribosomal DNA ( rDNA ) sequence analysis. The patient recovered after further treatment, including CT ‐induced pleural drain and intravenous imipenem. Totally, he received 2‐week imipenem and 1‐month metronidazole therapy from the day he was diagnosed with empyema to the termination of treatment. On the subsequent 2‐month and 6‐month follow‐up visits, no recurrence has been reported for this patient. Routine microbiological methods are important in diagnosis of pleural infection, but they have limitations in some cases, especially for anaerobe. Molecular assay based on 16S rDNA is helpful in detecting causative organisms of thoracic empyema.