Boerhaave's syndrome complicated by a Saccharomyces cerevisiae pleural empyema. Case report and review of the literature

Acta Clinica Belgica
Arno TeblickPhilippe G Jorens

Abstract

Objective and Importance Boerhaave's syndrome is a sudden and rare form of oesophageal rupture and is often complicated by local or systemic infection of the mediastinum or pleural cavity. Several micro-organisms are documented as cause of pleural empyema in patients with Boerhaave's syndrome. Intervention (& Technique) We report on a previously healthy 74-year-old male who was admitted at a regional hospital with severe retrosternal and abdominal pain after an episode of vigorous vomiting the morning after ingestion of large quantity of beer. A CT-scan confirmed the diagnosis of Boerhaave's syndrome, an oesophageal stent was placed and a left-sided pleural empyema necessitated chest tube drainage. Pleural fluid samples were cultured every two days and were positive for Proteus mirabilis on day 2 after admission and for Saccharomyces cerevisiae on day 8 after admission. Intravenous fluconazole 800 mg per day was added to the antibacterial treatment. Pleural fluid culture became negative for P. mirabilis on day 23 and for S. cerevisiae on day 13. Recurrent empyema necessitated intrapleural thrombolysis. The patient could be discharged from the ICU after 43 days, from the normal ward to a rehabilitation centre after an additional...Continue Reading

References

Feb 7, 2001·The American Journal of Clinical Nutrition·P R MarteauJ Schrezenmeir
Jul 11, 2002·Intensive Care Medicine·Thierry LhermClaire Malbrunot
Nov 4, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Adela Enache-Angoulvant, Christophe Hennequin
Jan 19, 2016·Frontiers in Microbiology·Roberto Pérez-Torrado, Amparo Querol

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Citations

Oct 28, 2019·Critical Reviews in Food Science and Nutrition·Rosanna TofaloCharles M A P Franz
Nov 26, 2020·Journal of Fungi·Lucas Weba SoaresMirelle Garcia Silva Bailão

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