Empyema Caused by Peptoniphilus asaccharolyticus and Complicated by Secondary Pulmonary Infection from Acinetobacter baumannii: A Case Report

Min Chai,1,* Patajiang Yusufu,2,* Yixin Chen,1 Jiannan Chai,3 Xinran Yang,1 Yuqi Xiao,1 Hongwei Long,4 Dilimulat Maimaiti,2 Dahai Xu1 1Department of Emergency Medicine, The First Hospital of Jilin University, Changchun, Jilin, People’s Republic of China; 2Department of Emergency Medicine, Seventh Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China; 3Department of Laboratory, The First Hospital of Jilin University, Changchun, Jilin, People’s Republic of China; 4Department of Neurosurgery, Meihekou Central Hospital, Changchun, Jilin, People’s Republic of China*These authors contributed equally to this workCorrespondence: Dahai Xu, Department of Emergency Medicine, The First Hospital of Jilin University, No. 1 Xinmin Street, Chaoyang District, Changchun, Jilin, People’s Republic of China, Tel +8615043032548, Email xudahai0319@jlu.edu.cn Dilimulat Maimaiti, Department of Emergency Medicine, Seventh Affiliated Hospital of Xinjiang Medical University, No. 1986, Qidaowan Road, Shuimogou District, Urumqi City, Xinjiang, People’s Republic of China, Tel +8617704972862, Email 3090760383@qq.comAbstract: Peptoniphilus asaccharolyticus is a gram-positive anaerobic coccus that can cause infections in immunocompromised individuals. P. asaccharolyticus causing empyema has not been reported earlier. Here, we present a novel case of empyema caused by P. asaccharolyticus. A 72-year-old male had a constant fever with difficulty breathing. A chest computed tomography scan revealed infiltration in the right lower lobe and pleural effusion. Following hospital admission, pleural fluid drainage was conducted, and the culture isolated P. asaccharolyticus. Initially treated with piperacillin/tazobactam, the patient experienced excessive thick sputum production, prompting a tracheostomy. Subsequent sputum cultures identified Acinetobacter baumannii. After transitioning to cefoperazone/sulbactam for antibiotic treatment and continued pleural effusion drainage, recovery was achieved. Empyema can be caused by P. asaccharolyticus and further complicated by a secondary infection with A. baumannii. Management should include appropriate antibiotic therapy, pleural drainage, vigilant monitoring, and supportive care. We aim to raise clinicians’ awareness of the potential for P. asaccharolyticus to cause empyema in immunocompromised patients and to provide early treatments, thereby improving morbidity and mortality.Keywords: Peptoniphilus asaccharolyticus, empyema, Acinetobacter baumannii, case report