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Case Reports
. 2023 Nov 1;15(11):e48117.
doi: 10.7759/cureus.48117. eCollection 2023 Nov.

Tannerella forsythia, Fusobacterium nucleatum, and Suspected Actinomyces Causing Massive Empyema: A Case Report

Courtney E Stewart  1 , Allison McCafferty  2 , Robert Sherertz  1
Affiliations
Case Reports

Tannerella forsythia, Fusobacterium nucleatum, and Suspected Actinomyces Causing Massive Empyema: A Case Report

Courtney E Stewart et al. Cureus. .

Abstract

This report presents the case of a polymicrobial empyema due to Fusobacterium nucleatum, Tannerella forsythia, and suspected Actinomyces spp., presenting as several weeks of progressive shortness of breath and malaise. The patient had many risk factors for a lower respiratory tract infection, including chronic alcohol abuse, a flu-like illness months prior, and a recent invasive dental procedure. An admission CT scan showed a large right pleural effusion. Blood cultures were negative, but an aspirate from the pleural effusion showed abundant gram-positive rods that did not grow aerobically. Subsequent anaerobic cultures at a reference laboratory grew Tannerella forsythia and Fusobacterium nucleatum. This report will review the diagnostic difficulties associated with anaerobic causes of empyema in general and the specific organisms implicated in this case.

Keywords: actinomyces; anaerobes; empyema; fusobacterium nucleatum; tannerella forsythia.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Images from CT thorax with contrast
Images A to E: Anteroposterior (AP) view; Image F: Coronal view Note the air pockets within the fluid collection
Figure 2
Figure 2. Histopathology images
A. Gram stain of pleural fluid obtained during video-assisted thoracoscopic surgery (VATS) procedure. Arrows pointing at clumps of gram-positive rods. B. Gram-positive rods from A, magnified.
See this image and copyright information in PMC

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