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Pyopneumothorax secondary to Streptococcus milleri infection
  1. Mohd Jazman Che Rahim1,
  2. Nurashikin Mohammad2,
  3. Wan Syamimee Wan Ghazali2
  1. 1Department of Medical, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
  2. 2Department of Internal Medicine, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
  1. Correspondence to Dr Wan Syamimee Wan Ghazali, mimeeghazali{at}


We report a case of a 46-year-old Malay woman with underlying hypothyroidism post thyroidectomy who presented with worsening breathlessness, orthopnoea, productive cough and left-sided pleuritic chest pain of 3 days duration. Chest X-ray on admission showed left-sided massive hydropneumothorax. Pleural tapping revealed empyema. A chest tube was inserted immediately. The culture of pleural fluid grew Streptococcus constellatus. The patient was treated with antibiotics for a total of 6 weeks and underwent open thoracotomy and decortication during admission. Subsequently, her lung condition improved and there was no evidence of recurrence during follow-up.

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  • Contributors MJCR drafted the manuscript. NM and WSWG approved the final manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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