Streptomyces infection in Cushing syndrome: A case report and literature review

Streptomyces are saprophytic soil organisms rarely known to cause invasive infections. Streptomyces is the largest genus, producing antibacterial, antifungal and antiparasitic drugs. The case was a 24-year-old man, admitted for sudden dyspnea, fever and sputum and decreased sound in the left lung. The chest X-ray showed hydropneumothorax. After chest tube insertion, lung expansion did not happen. Pleural effusion was exudative with gram-positive bacillus and Streptomyces in culture. Owing to symptoms of Cushing in history, examination and laboratory work-up for Cushing was done and finally he underwent bilateral adrenalectomy. The patient was on antibiotic broad spectrum antibiotic and then was changed to antibiotic as organism was sensitive to and discharged with clarithromycin for 6 months. Streptomyces happens in immunodeficient patient. Diagnosis is based on culture and contamination was ruled out. Treatment period is longer for patients owing to slow growing nature.