CTICasesCampylobacter rectus and Fusobacterium Empyema with Bronchopleural Fistula
Imaging findings
Chest radiograph shows multiple air-fluid levels and a lateral pleural stripe. CT reveals loculated pleural fluid collections containing gas, prominent pleural thickening and enhancement, and a visible bronchopleural fistula directly connecting the central airways to the pleural space. Striking hypertrophy of the extrapleural fat is also seen on the affected side.
Key takeaways
Empyema with a visible bronchopleural fistula can develop rapidly and cause significant extrapleural fat hypertrophy and mediastinal traction. Culturing anaerobic oral or GI organisms like Campylobacter rectus and Fusobacterium species points to aspiration, and gastric acid suppression (e.g., omeprazole) can increase susceptibility to Campylobacter infections.
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