Successful Interventional Treatment of Pyopneumothorax Caused by Streptococcus constellatus Associated with Hashimoto’s Thyroiditis: A Case Report and Literature Review

Hongxia Wang,1,* Fating Zhou,2,* Zhilin Li,1 Yulan Ding,1 Qian Wen,1 Quanxing Tang1 1Department of General Practice, People’s Hospital of Deyang City, Deyang, Sichuan, People’s Republic of China; 2Emergency Department, Chongqing Emergency Medical Center, Chongqing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hongxia Wang, Department of General Practice, People’s Hospital of Deyang City, Deyang, Sichuan, People’s Republic of China, Email HongXia.W@hotmail.comBackground: Streptococcus constellatus rarely causes pyopneumothorax, which is a serious state and requires a surgery. However, not every patient can tolerate surgery and individualized solutions are needed. Furthermore, many known situations are risk factors of S. constellatus infection, but S. constellatus pyopneumothorax associated with Hashimoto’s thyroiditis has not been reported.Case Presentation: We present the case of a 74-year-old male with multiple encapsulated pyopneumothorax caused by S. constellatus. Given his respiratory failure, we provided two-stage percutaneous right empyema radiography for catheter drainage in the radiology interventional department instead of surgery. Moreover, an occult Hashimoto’s thyroiditis was discovered in the patient, which was possibly associated with S. constellatus pyopneumothorax. Levothyroxine was administered to improve his situation.Conclusion: To our knowledge, it is the first case described in this context. We provided an alternative treatment for S. constellatus encapsulated pyopneumothorax in patient who might not tolerate surgery. We also revealed the possible relationship between S. constellatus pyopneumothorax and Hashimoto’s thyroiditis.Keywords: radiology interventional, Streptococcus constellatus, pyopneumothorax, Hashimoto’s thyroiditis