Clostridium perfringens empyema in a patient with metastatic squamous cell carcinoma of the lung

We report a rare case of Clostridium perfringens (CP) empyema in a patient with metastatic squamous cell cancer of the lung. Clostridial empyemas are rare and clinically variable with some reports noting consequent necrotizing infections and septic shock and others noting quick resolution with source control and antibiotic treatment. This is the first case report to our knowledge to report a CP empyema in a patient with lung malignancy. Given the comorbid lung malignancy, the patient's presenting symptoms were mild with only mild shortness of breath, fevers, and generalized weakness despite the large CP empyema. Early antibiotics and source control with daily drainage of the pleural fluid allowed for successful management, circumventing a complex critical care course and successful management without ambulatory oxygen therapy on discharge.