Objective To investigate the clinical features,imaging features,diagnosis and treatment of empyema caused by Streptococcus constellatus for improving early diagnosis and treatment and reduce mortality rate.Methods The clinical data of 11 patients with empyema caused by S.constellatus who were treated in Fuding Hospital of Fujian Province from February 2021 to August 2024 were retrospectively analyzed.Results All the 11 patients were male,51 to 78 years old.Underlying disease was reported in 9 patients.The main clinical manifestations were chest tightness and dyspnea.Fever may not be present.The white blood cell count,neutrophil ratio,C-reactive protein,procalcitonin,fibrinogen and D-dimer were significantly increased in 11 patients.Chest imaging showed unilateral encapsulated effusion,more common on the right side(9/11),and sometimes accompanied by pneumothorax(2/10).The lung lobes of the same side of empyema were mostly accompanied by exudation and consolidation,and cavities were common(6/10)in the consolidation lesions.White blood cells,multinucleated cells,lactate dehydrogenase(LDH)and adenosine deaminase(ADA)were significantly increased in pleural effusion of 11 patients.The positive rate of pleural effusion culture in aerobic bottle(10/11)and anaerobic bottle(6/7)was higher than that in blood plate culture(1/7).All the 11 patients were treated with antibiotics combined with thoracentesis and drainage.Ten patients improved after treatment.One patient died of septic shock in a short time.Conclusions Drainage of pleural effusion and pleural fluid culture should be performed as soon as possible for middle-aged and elderly male patients with underlying diseases,acute or subacute onset of chest distress,dyspnea,associated with significantly increased blood inflammatory markers,and chest imaging suggesting pleural effusion.Pleural fluid can be injected into the blood culture bottle to improve the detection of S.constellatus.At the same time,antimicrobial therapy should be prescribed reasonably according to the results of antimicrobial susceptibility test.

Objective To investigate the clinical features,imaging features,diagnosis and treatment of empyema caused by Streptococcus constellatus for improving early diagnosis and treatment and reduce mortality rate.Methods The clinical data of 11 patients with empyema caused by S.constellatus who were treated in Fuding Hospital of Fujian Province from February 2021 to August 2024 were retrospectively analyzed.Results All the 11 patients were male,51 to 78 years old.Underlying disease was reported in 9 patients.The main clinical manifestations were chest tightness and dyspnea.Fever may not be present.The white blood cell count,neutrophil ratio,C-reactive protein,procalcitonin,fibrinogen and D-dimer were significantly increased in 11 patients.Chest imaging showed unilateral encapsulated effusion,more common on the right side(9/11),and sometimes accompanied by pneumothorax(2/10).The lung lobes of the same side of empyema were mostly accompanied by exudation and consolidation,and cavities were common(6/10)in the consolidation lesions.White blood cells,multinucleated cells,lactate dehydrogenase(LDH)and adenosine deaminase(ADA)were significantly increased in pleural effusion of 11 patients.The positive rate of pleural effusion culture in aerobic bottle(10/11)and anaerobic bottle(6/7)was higher than that in blood plate culture(1/7).All the 11 patients were treated with antibiotics combined with thoracentesis and drainage.Ten patients improved after treatment.One patient died of septic shock in a short time.Conclusions Drainage of pleural effusion and pleural fluid culture should be performed as soon as possible for middle-aged and elderly male patients with underlying diseases,acute or subacute onset of chest distress,dyspnea,associated with significantly increased blood inflammatory markers,and chest imaging suggesting pleural effusion.Pleural fluid can be injected into the blood culture bottle to improve the detection of S.constellatus.At the same time,antimicrobial therapy should be prescribed reasonably according to the results of antimicrobial susceptibility test.