{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:21:21Z","timestamp":1788182481022,"version":"build-2803163510"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Pleural empyema is usually a complication of pneumonia caused by common bacteria such as\n                    <jats:italic toggle=\"yes\">Streptococcus pneumoniae<\/jats:italic>\n                    or\n                    <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                    . Empyema due to\n                    <jats:italic toggle=\"yes\">Enterococcus faecalis<\/jats:italic>\n                    is exceedingly rare, especially in the immunocompetent individuals. We report the case of a 75-year-old male with no significant immunosuppression who presented with progressive dyspnea and pleuritic chest pain. Imaging revealed a loculated right-sided pleural effusion. Thoracentesis yielded purulent fluid and culture grew\n                    <jats:italic toggle=\"yes\">E. faecalis<\/jats:italic>\n                    . The patient was treated successfully with chest tube drainage, broad-spectrum antibiotics, and intrapleural fibrinolytic therapy (streptokinase) without requiring surgical decortication. He made a full recovery with complete lung re-expansion. This rare case highlights that\n                    <jats:italic toggle=\"yes\">E. faecalis<\/jats:italic>\n                    can cause empyema even in immunocompetent patients. Early recognition, image-guided drainage, appropriate antibiotics, and adjunctive intrapleural fibrinolysis can lead to favorable outcomes, avoiding invasive surgery.\n                  <\/jats:p>","DOI":"10.4103\/aam.aam_373_25","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T11:00:07Z","timestamp":1763550007000},"page":"1328-1331","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Uncommon Etiology of Pleural Empyema: Enterococcus faecalis in an Immunocompetent Host"],"prefix":"10.4103","volume":"25","author":[{"given":"Sanjay","family":"Gabhale","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parna","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brahmansh","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"R1-20260831","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1007\/s15010-007-6359-6","article-title":"Pleural Enterococcus faecalis empyema: An unusual case","volume":"37","author":"Bergman","year":"2009","journal-title":"Infection"},{"key":"R2-20260831","first-page":"101375","article-title":"Pleural empyema due to Enterococcus species: An uncommon etiology","volume":"32","author":"Mohanty","year":"2021","journal-title":"Respir Med Case Rep"},{"key":"R3-20260831","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1097\/00007611-200295100-00019","article-title":"Enterococcus faecalis causing empyema in a patient with liver disease","volume":"95","author":"Behnia","year":"2002","journal-title":"South Med J"},{"key":"R4-20260831","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1513\/AnnalsATS.201711-848PS","article-title":"Intrapleural Fibrinolytic Therapy for Empyema and Pleural Loculation: Knowns and Unknowns","volume":"15","author":"Idell","year":"2018","journal-title":"Ann Am Thorac Soc"},{"key":"R5-20260831","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1056\/NEJMoa1012740","article-title":"Intrapleural use of tissue plasminogen activator and DNase in pleural infection","volume":"365","author":"Rahman","year":"2011","journal-title":"N Engl J Med"},{"key":"R6-20260831","doi-asserted-by":"crossref","first-page":"54","DOI":"10.5578\/tt.2449","article-title":"Thoracic empyema due to bacterial translocation in acute appendicitis","volume":"61","author":"Tokat","year":"2013","journal-title":"Tuberk Toraks"},{"key":"R7-20260831","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1016\/S2213-2600(20)30533-6","article-title":"Use of fibrinolytics and deoxyribonuclease in adult patients with pleural empyema: A consensus statement","volume":"9","author":"Chaddha","year":"2021","journal-title":"Lancet Respir Med"},{"key":"R8-20260831","first-page":"54","article-title":"Benefit of intrapleural fibrinolytic therapy in the treatment of complicated parapneumonic effusion and empyema","volume":"47","author":"Merhabene","year":"2024","journal-title":"Pan Afr Med J"},{"key":"R9-20260831","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1186\/s12890-018-0726-1","article-title":"Pleural infection: A retrospective study of clinical outcome and the correlation to known etiology, co-morbidity and treatment factors","volume":"18","author":"Meyer","year":"2018","journal-title":"BMC Pulm Med"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_373_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:00:50Z","timestamp":1788181250000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_373_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,19]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_373_25","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,19]]},"assertion":[{"value":"2025-07-25","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-19","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}