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Rapid developing empyema by group F beta Streptococcus anginosus group
  1. Muhammad Azharuddin,
  2. Dy Prudence,
  3. Prem Shanker Shukla,
  4. Ajay Mathur
  1. Department of Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA
  1. Correspondence to Dr Muhammad Azharuddin, azhar_uddin203{at}


A 43-year-old male had progressive pleuritic left-sided chest tightness with shortness of breath. He had dental caries and tenderness on palpation of the left lateral chest. Complete blood count showed leucocytosis. CT scan of the chest with pulmonary emboli protocol showed multiple pulmonary nodules and nodular pleural thickening at left posterior lateral pleura. Forty-eight hours post CTPE scan, CT scan of the chest, abdomen and pelvis displayed right lower lobe consolidation and left-sided pleural effusion with superimposed compressive atelectasis. Ceftaroline intravenous was initiated, with CT-guided pigtail chest tube insertion. Pleural fluid later grew group F beta-haemolytic Streptococcus anginosus. Patient improved significantly and was discharged 11 days later with intravenous ertapenem. Patients with group F beta-haemolytic streptococci should be managed aggressively with early and accurate diagnosis, antibiotics, drainage and possible surgery.

  • Pneumonia (infectious disease)
  • Radiology
  • Respiratory medicine
  • Smoking and tobacco
  • Cardiothoracic surgery

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  • Contributors All authors contributed equally to the making of this manuscript. DP and PSS worked with the patient and composed the first draft of the case. MA and AM worked on the second draft and finalised it.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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