Abstract：
BACKGROUND: Despite the advance in antibiotics and widespread chest tube drainage, acute empyema still shows a high mortality rate, accounting for 10-25%. We experienced a case of acute empyema caused by A. hydrophila, which is extremely uncommon, and reviewed all previously published articles.
METHODS: A 76-year older man with a medical history of liver cirrhosis (LC) due to chronic hepatitis C and hepatic cell carcinoma was admitted to our institute. Elevated inflammatory reaction and effusions on chest CT were seen, and he was suspected of having acute empyema. Although an empiric antibiotic therapy of meropenem with chest tube drainage was performed as an initial treatment, he died within 8 hours of admission. Postmortem, both blood and left pleural fluid cultures yielded Aeromonas hydrophila. The final diagnosis was acute empyema caused by A. hydrophila. We reviewed previously reported empyema caused by Aeromonas species cases (4 A. hydrophila, and 1 A. veronii) in 4 previous reports written in English, including ours. Of 5, all were male, and the mean age was 52 years (range 27-76 years). All patients had LC due to alcohol or viral infections. As for antibiotics initially prescribed, third-generation cephalosporins were most frequently used in 3/5 (60%). Thoracentesis was performed in all patients (100%). As for prognosis, 2 (40%) survived, and 3 (60%) died.
CONCLUSIONS: Physicians should be aware of the possibility of acute empyema caused by A. hydrophila among patients with chronic hepatic disease.
METHODS: A 76-year older man with a medical history of liver cirrhosis (LC) due to chronic hepatitis C and hepatic cell carcinoma was admitted to our institute. Elevated inflammatory reaction and effusions on chest CT were seen, and he was suspected of having acute empyema. Although an empiric antibiotic therapy of meropenem with chest tube drainage was performed as an initial treatment, he died within 8 hours of admission. Postmortem, both blood and left pleural fluid cultures yielded Aeromonas hydrophila. The final diagnosis was acute empyema caused by A. hydrophila. We reviewed previously reported empyema caused by Aeromonas species cases (4 A. hydrophila, and 1 A. veronii) in 4 previous reports written in English, including ours. Of 5, all were male, and the mean age was 52 years (range 27-76 years). All patients had LC due to alcohol or viral infections. As for antibiotics initially prescribed, third-generation cephalosporins were most frequently used in 3/5 (60%). Thoracentesis was performed in all patients (100%). As for prognosis, 2 (40%) survived, and 3 (60%) died.
CONCLUSIONS: Physicians should be aware of the possibility of acute empyema caused by A. hydrophila among patients with chronic hepatic disease.
摘要：
背景：尽管抗生素的进步和广泛的胸腔引流，急性脓胸仍然显示出很高的死亡率，占10-25%。我们经历了一例由嗜水菌引起的急性脓胸，这非常罕见，并回顾了以前发表的所有文章。
方法：我们研究所收治了一名76岁的男性，他有慢性丙型肝炎和肝细胞癌引起的肝硬化（LC）病史。胸部CT显示炎性反应和积液升高，他被怀疑患有急性脓胸。尽管作为初始治疗进行了美罗培南的经验性抗生素治疗并进行了胸管引流，他在入院后8小时内死亡。死后,血液和左胸膜液培养均产生嗜水气单胞菌。最终诊断为嗜水气单胞菌引起的急性脓胸。我们回顾了以前报道的由气单胞菌引起的脓胸（4A。嗜水菌，和1A.veronii)在以前的4份英文报告中，包括我们的.五个人中，都是男性，平均年龄为52岁（范围27-76岁）。所有患者因酒精或病毒感染而患有LC。至于最初开的抗生素，第三代头孢菌素最常用于3/5(60%).所有患者均进行了胸腔穿刺术（100%）。至于预后，2（40％）存活，3人（60%）死亡。
结论：医师应意识到慢性肝病患者中嗜水气单胞菌引起急性脓胸的可能性。
方法：我们研究所收治了一名76岁的男性，他有慢性丙型肝炎和肝细胞癌引起的肝硬化（LC）病史。胸部CT显示炎性反应和积液升高，他被怀疑患有急性脓胸。尽管作为初始治疗进行了美罗培南的经验性抗生素治疗并进行了胸管引流，他在入院后8小时内死亡。死后,血液和左胸膜液培养均产生嗜水气单胞菌。最终诊断为嗜水气单胞菌引起的急性脓胸。我们回顾了以前报道的由气单胞菌引起的脓胸（4A。嗜水菌，和1A.veronii)在以前的4份英文报告中，包括我们的.五个人中，都是男性，平均年龄为52岁（范围27-76岁）。所有患者因酒精或病毒感染而患有LC。至于最初开的抗生素，第三代头孢菌素最常用于3/5(60%).所有患者均进行了胸腔穿刺术（100%）。至于预后，2（40％）存活，3人（60%）死亡。
结论：医师应意识到慢性肝病患者中嗜水气单胞菌引起急性脓胸的可能性。
