Chlamydia pneumoniae pneumonia with pleural effusion: diagnosis by culture

The case report is presented of a 19-year-old man who developed malaise, severe chest pain, a cough, and weight loss. The patient had been taking an antibiotic (cephalexin) for seven days without relief, and shortness of breath had developed. A different antibiotic (erythromycin) was prescribed, but it caused gastrointestinal discomfort and the patient stopped taking it. After admission to the hospital, the patient's respiratory symptoms worsened and treatment with intravenous erythromycin was started. X-ray studies showed lung abnormalities. A pleural effusion (presence of fluid in the pleural space, between the layers of membrane that surround the lungs) was detected and aspirated. This brought prompt relief of symptoms. Examination of swab specimens from the patient's throat and of the pleural fluid showed that the bacteria Chlamydia pneumoniae was present. This agent can cause a mild to moderately severe pneumonia, often with sore throat, in healthy young adults. It can also affect older people, requiring hospitalization. This represents the first reported case in which C. pneumoniae has been isolated from pleural fluid. (Consumer Summary produced by Reliance Medical Information, Inc.)