Streptococcus acidominimus isolated from a multiloculated empyema in a critically ill adult man with pneumonia: Case report and review of literature

We describe a 55-year-old man with a medical history of hypertension and schizophrenia who presented to the medical intensive care with delirium and respiratory failure requiring intubation. Chest radiography showed a complete opacification of the right hemithorax. Subsequent chest computed tomography with contrast confirmed a multiloculated right pleural effusion, compressive atelectasis, and mediastinal shift to the left. This patient required multiple tube thoracostomies and a video-assisted thoracoscopic decortication to adequately drain the multiloculated empyemas. Streptococcus acidominimus, a common bacterial pathogen in veterinary medicine, was isolated. The organism is an uncommon cause of invasive disease in humans. This is the first case report in which S. acidominimus was isolated from a multiloculated empyema in a critically ill patient causing significant morbidity and must be considered as a potential but rare pathogen.