Streptococcus intermedius empyema in an adolescent with a history of vaping: A case report

Abstract

We present a 17-year-old male patient with persistent community acquired pneumonia resistant to outpatient antibiotic therapy resulting in S. intermedius empyema. Diagnosis was confirmed and treated by video assisted thoracoscopic surgery (VATS) with chest tube placement and TPA injection. An organism native to the human oral microbiome, S. intermedius is known to cause pneumonia and empyema in elderly adults with severe comorbidities and risk factors, neither of which apply to this patient. One potential risk factor for this infection in our patient is heavy, chronic vaping of electronic cigarettes with nicotine. Previous studies have shown a connection between these products and pulmonary infections, but a connection to S. intermedius infection has not been reported in pediatric patients. This example of S. intermedius empyema in a pediatric patient may motivate further research into the mechanism of vaping-related lung infection and empyema, particularly in younger patients.

Keywords

• Case report
• Pediatric empyema
• S. intermedius
• VATS
• Vaping