Most common organism causing SBPE after E. coli is
(C) Streptococcus # Spontaneous Bacterial Empyema currently re-termed as pleuritis (SBPe) is the spontaneous infection of the pleural fluid> Its prevalence is seen in 13% of in-hospital cirrhosis patients with hydrothorax and has an estimated morality of over 20% in the same admission.> It is postulated to occur as a direct spread of bacteria from the peritoneal cavity. In 40% patients for SBPe, there is no associated SBP.> SBPe can also occur in the absence of ascites.> Another theory regarding its pathogenesis is that transient bacteremia that infects the pleural space.> Defective local pleural factors such as low fluid complement levels and low opsonic activity (similar to that seen in ascites that develop SBP) is also seen in SBPe pathogens, which enhances bacterial translocation.> Causative micro-organism in most cases of SB EM are E. coli, Streptococcus species, Enterococcus & Klebsiella, which are different from that causing SBP.> A high child-Pugh score, decreased pleural fluid total protein and low levels of C3 component in pleural fluid were proved risk factors for the development of SBEM SBP is also a predictive factor of SBEM.> It is recommended to use the pleural fluid total protein concentration in clinical practice to detect those patients at a risk for developing SBEM.
Klebsiella
Bacteroids
Streptococcus
Enterococcus
Miscellaneous