Isolation of Streptococcus pyogenes from pleural fluid in a critically ill patient: a case report with a rare occurrence

Isolation of Streptococcus pyogenes in pleural fluid

Abstract

Transudative or exudative pleural effusion has a diverse etiology including bacteria that differ depending upon hospital or community acquired infections. Most bacterial organisms isolated from pleural fluid include Gram positive bacteria including Staphylococcus aureus, Streptococcus pneumoniae and Streptococcus viridans followed by Gram negative bacteria. The Isolation of Streptococcus pyogenes (Group A Lancefield Group) from pleural fluid is unusual as this bacterium is responsible for causing skin and throat infections which range from asymptomatic cases to full blown symptomatic toxic shock syndrome. Patients with various comorbidities may have the worst prognosis and severe complications from asymptomatic or confirmed infections.
We report a case study of a patient with isolation of Streptococcus pyogenes from pleural fluid, This is a rare finding, but may happen owing to dysbiosis associated with systemic insufficiencies. To our understanding this is the first reported case in Pakistan of Streptococcus pyogenes isolation from pleural fluid.