Caspian Journal of Internal Medicine
1
Caspian J Intern Med
Medical Sciences
http://caspjim.com
1
admin
2008-6164
2008-6172
8
10.22088/cjim
14
8888
13
en
jalali
1399
12
1
gregorian
2021
3
1
12
2
online
1
fulltext
en
Concomitant Empyema and Peritonitis with Morganella Morganii in an Immunocompetent Patient: A Case Report
Pulmonology
Pulmonology
case report
case report
<span style="font-family:Times New Roman;"><span style="color:#0033ff;"><strong><em>Background</em></strong><em>:</em> </span>Peritoneal infection following pleural empyema is not a common occurrence. Concomitant pleural empyema and peritonitis have been described in the literature mostly in immunocompromised patients with different pathogenic mechanisms and a wide array of microorganisms. Here we report a case of concomitant pleural empyema and peritonitis with an unusual microorganism in an immunocompetent host.<br>
<span style="color:#0033ff;"><strong><em>Case presentation:</em></strong></span> The patient is a 42-year-old man with a history of 2 weeks epigastric pain who had been referred for surgical consult after failure of outpatient medical therapy. Physical examination at emergency ward revealed generalized abdominal guarding, tenderness and rebound tenderness. On emergent laparotomy, the peritoneal cavity was full of malodor pus. All abdominal viscera were intact but there was a 2x2 centimeter defect in the top of left hemi-diaphragm. Pus originated from the left thoracic cavity and then drained to the peritoneal cavity. <em>Morganella morganii</em> grew in the culture of aspirated pleural fluid. After abdominal lavage and chest tube drainage and receiving 14 days course of parenteral antibiotics, the patient experienced marked clinical improvement. Punctual history taking revealed a history of pneumonia before the beginning of abdominal symptoms.<br>
<span style="color:#0033ff;"><strong><em>Conclusion:</em></strong></span> In concomitant empyema and peritonitis in an immunocompetent patient, one should keep in mind the possibility of diaphragmatic defect and infection by unusual organisms like <em>M. </em><em>m</em><em>organii.</em></span>
Empyema, Peritonitis, Diaphragmatic Defect, Morganella Morganii, pyopneumothorax
232
235
http://caspjim.com/browse.php?a_code=A-10-648-2&slc_lang=en&sid=1
Mahnaz
Amini
aminim@mums.ac.ir
100319475328460028203
100319475328460028203
No
Department of Pulmonary and Critical Care Medicine, Lung Diseases Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mohammad Reza
Motie
motiem@mums.ac.ir
100319475328460028204
100319475328460028204
Yes
Department of Surgery, Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Saeid
Amel Jamehdar
ameljs@mums.ac.ir
100319475328460028205
100319475328460028205
No
Antimicrobial Resistance Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
Mohammad Reza
Kasraei
kasraeimr@mums.ac.ir
100319475328460028206
100319475328460028206
No
Department of Pulmonary and Critical Care Medicine, Lung Diseases Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mansoore
Sobhani
sobhanim921@mums.ac.ir
100319475328460028207
100319475328460028207
No
Lung Diseases Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran