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10 - A case of multiple staphylococcic abscesses and empyema in a young adult
Recep Dodurgali, Levent Dalar, Sezai Öztürk, Cemal Bes, Hanife Can, Kerim Küçükler, Firdevs Atabey, Arzu Koç, Çiğdem Y. Ersoy, Arman Poluman
A 24 years old male patient who presented with fever, cough, weight loss, pain in the right shoulder and chest as well as swelling with severe pain in the right thigh, has been hospitalized in our clinic. These symptoms were present since one month and with no response to wide spectrum antibiotics administered under non-hospitalized conditions. Cachexia, inadequate oral hygiene and limitations of movements were also observed. Non respiratory sounds could be heard on the right with auscultation and there was extensive dullness. A fluctu¬ating hot abscess of approximately 10X10 cm diameter was detected on the right thigh. 12 600/mm3 of leucocytes, a shift to the left in the formula, normocytic anemia were also noted. In his chest X-ray, diffuse homogenius density at the right and at the thorax CT, locular, encysted pleural effusion was detected. At CT sections obtained from femoral level, two collections of abscess were observed on the right. Pleural and abscess fluid cultures were Stafilococcus aureus positive. Immune deficiency that was also observed clinically was confirmed by lymphocytes subpopulation analysis. Cefasolin at 2 g/day doses has been administered for I month for treatment.
As the patient was not belonging to the child, or elderly population and he did not presented with nasocomial infection characteristics, it was considered as a staphylococcic infection case with a course of multilocular abscesses and encysted pleural empyema as a result of a possible sepsis due to staphylococci of the mouth flora.
Keywords: S. aureus, Empyema, Multiple abscesses
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