Introduction:

the Streptococcus genus is a very heterogeneous group of bacteria. Thanks to molecular biology, several species have been identified. Streptococcus plurianimalium (S plurianimalium) is a gram-positive coccus grouped in chains; it is a ubiquitous microorganism that, although described as disease inducing in animals, it has pathogenic capacity in humans. Pleural empyema is the accumulation of pus in the pleural space and it is caused by infection.

Objectives:

the objective of this paper is to present the first case of empyema dueto S plurianimalium described in our country.

Methodology:

for the report, the patient’s medical record was used as data source, protecting the patient’s identity during the reporting process.

Results:

7-year-old female patient from Maldonado Department. Personal history of overweight, dental septic foci, current vaccination schedule card. Consulted in the emergency service for cough with expectoration, fever of 38°, pain in the anterior aspect of the left hemithorax. A blood count was requested, showing leukocytosis with neutrophilia. Normocytic, normochromic anemia. Increae in acute phase reactants. The chest X-ray showed a consolidation focus at the base of the left hemithorax. She was admitted to moderate care and in the evolution, she added pleural effusion. A chest ultrasound was performed, which quantified the effusion, and then a thoracentesis was performed, where the diagnosis of pleural empyema was confirmed by the cytochemical study of the fluid. She was transferred to intermediate care and a chest tube was placed. A chest tomography was performed, showing areas of destruction of the pulmonary parenchyma. The bacteriological study of the pleural fluid reported the identification of S plurianimalium. The patient remained hospitalized for 38 days in total. She received 21 days of Ceftriaxone, 11 of Vancomycin and 15 of Piperacillin tazobactam. During her hospitalization, she presented a respiratory infection due to Adenovirus and a slow-growing microorganism, Eikenela corrodens, was also isolated from the pleural fluid. Tuberculosis was ruled out in the etiological search and a study to detect human immunodeficiency virus was performed, which was negative.

Conclusions:

at the present time there are no reports of cases of infections by S plurianimalium in pediatrics in our country and there are few reports worldwide. The majority are infectious endocarditis, pneumonias, fasciitis, in adults. Our patient presented a torpid empyema, with elements of severity. The association with other germs is described in the international literature, as shown by of our patient. Several antibiotic regimens were used since there is no clear protocolized guide in the case of this microorganism. She required thoracoscopy for debridement and pleural drainage. Alteplase® was used as fibrinolytic therapy with good results. We emphasize the importance of working closely with a pediatric surgeon and microbiologist when addressing these patients.

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