Empyema Caused by Pasteurella multocida in a Patient With Chronic Obstructive Respiratory Disease Taking Inhaled Corticosteroids: A Case Report

Pasteurella multocida (P. multocida) infection develops in patients with chronic obstructive pulmonary disease (COPD). Inhaled corticosteroids (ICS) are used for the treatment of COPD. Herein, we report a case of empyema caused by P. multocida in a patient using ICS for COPD. A 79-year-old man with COPD presented with general fatigue. He was treated with triple therapy including ICS. Contrast-enhanced computed tomography revealed encapsulated pleural effusion in the left chest. We initiated antibiotics, sulbactam sodium/ampicillin sodium (3 g × 4), and thoracic drainage. His pleural effusion culture turned out positive and P. multocida was detected. The patient was diagnosed with empyema caused by P. multocida. The triple therapy combination, including ICS, was changed to a double therapy combination without ICS. The subsequent progress was relatively good, and on the 49th day of hospitalization, the patient was discharged. The onset of P. multocida infection may be associated with ICS use, which may best be avoided in a patient with COPD who is at risk of P. multocida infection.