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Complicated Thoracic Empyema of Serotype 23F Streptococcus pneumoniae in an Adult Patient

ACTA MEDICA INDONESIANA · Vol. 57 No. 4 (2025)

ISSN
2338-2732, 0125-9326
Terbit
2025-12-23
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng
Lisensi
creativecommons.org/licenses/by/4.0

Abstrak

We report a case of thoracic empyema in a 61-year-old male patient, a heavy smoker with malignancy undergoing chemotherapy. The patient’s clinical symptoms included shortness of breath, productive cough, fever, and chest pain. This patient had never received antibiotics before. Streptococcus pneumoniae was isolated from a bedside culture of empyema fluid collected through thoracentesis. The empyema fluid was cultured on chocolate agar plates and in aerobic and anaerobic culture bottles. The isolate was identified as serotype 23F, a vaccine strain with sequence type 17532. The isolate was resistant to chloramphenicol, tetracycline, and cotrimoxazole. The patient clinically improved with the administration of combined intravenous ceftriaxone and levofloxacin antibiotics, along with chest tube drainage via thoracostomy. This is the first report of thoracic empyema caused by S. pneumoniae in an adult in Indonesia. Serotype 23F is multi-resistant with low invasiveness, typically causing infections in patients with underlying health conditions. The pneumococcal conjugate vaccine covers it; thus, it usually occurs in areas with low vaccine coverage. Our findings support the importance of improving adult pneumococcal vaccination coverage in Indonesia.

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  • Universitas Halu Oleo
  • Kementerian Kesehatan Republik Indonesia
  • Cenderawasih University
  • Hasanuddin University
  • Politeknik Negeri Samarinda
  • Afiliasi tidak diketahui
  • Organisasi berbeda
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Rekan penulisOrganisasiArtikel bersama
Suharty RoslanUniversitas Halu Oleo4
La Ode Monto BautoUniversitas Halu Oleo3
Muhammad RusliUniversitas Halu Oleo3
Bahtiar BahtiarUniversitas Halu Oleo3
Sulsalman MoitaUniversitas Halu Oleo2
Juhaepa JuhaepaUniversitas Halu Oleo2
Muhammad ArsyadUniversitas Halu Oleo2
Mirna WidiyantiKementerian Kesehatan Republik Indonesia2
Antonius OktavianCenderawasih University2
Sumarlin SumarlinUniversitas Halu Oleo1
Dewi AnggrainiAfiliasi tidak diketahui1
Rahman TandiAfiliasi tidak diketahui1
Ratnawati RatnawatiHasanuddin University1
Marliana MarlianaAfiliasi tidak diketahui1
Rety Reka MerlinsAfiliasi tidak diketahui1
Iksan Mail SyahAfiliasi tidak diketahui1
Keli SartikaAfiliasi tidak diketahui1
Sarman SarmanUniversitas Halu Oleo1
Usnia UsniaAfiliasi tidak diketahui1
Ardi YusufAfiliasi tidak diketahui1
Angga SaputraPoliteknik Negeri Samarinda1
Nirmawati NirmawatiAfiliasi tidak diketahui1
Orin OrinAfiliasi tidak diketahui1
Amnia AmniaAfiliasi tidak diketahui1
Alimuddin AlimuddinAfiliasi tidak diketahui1
La AlimanAfiliasi tidak diketahui1
Tahrun KokoUniversitas Halu Oleo1
Hj. Suharty RoslanAfiliasi tidak diketahui1
Wa SarianaAfiliasi tidak diketahui1
Ilham IlhamAfiliasi tidak diketahui1
Susianti SusiantiAfiliasi tidak diketahui1

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Sumber metadata: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
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	<dc:title xml:lang="en-US">Complicated Thoracic Empyema of Serotype 23F Streptococcus pneumoniae in an Adult Patient</dc:title>
	<dc:creator>Yovi, Indra</dc:creator>
	<dc:creator>Safari, Dodi</dc:creator>
	<dc:creator>Syah, Nur Afrainin</dc:creator>
	<dc:creator>Anggraini, Dewi</dc:creator>
	<dc:creator>Sarassari, Rosantia</dc:creator>
	<dc:creator>Maladan, Yustinus</dc:creator>
	<dc:creator>Azzahrah, Ayummi</dc:creator>
	<dc:creator>Pelawi, Nicholas Gilbert</dc:creator>
	<dc:creator>Elliyanti, Aisyah</dc:creator>
	<dc:subject xml:lang="en-US">pulmonology</dc:subject>
	<dc:subject xml:lang="en-US">infection</dc:subject>
	<dc:subject xml:lang="en-US">Streptococcus pneumonia</dc:subject>
	<dc:subject xml:lang="en-US">Thoracic empyema</dc:subject>
	<dc:subject xml:lang="en-US">adult patient</dc:subject>
	<dc:subject xml:lang="en-US">Serotype 23F</dc:subject>
	<dc:description xml:lang="en-US">We report a case of thoracic empyema in a 61-year-old male patient, a heavy smoker with malignancy undergoing chemotherapy. The patient’s clinical symptoms included shortness of breath, productive cough, fever, and chest pain. This patient had never received antibiotics before. Streptococcus pneumoniae was isolated from a bedside culture of empyema fluid collected through thoracentesis. The empyema fluid was cultured on chocolate agar plates and in aerobic and anaerobic culture bottles. The isolate was identified as serotype 23F, a vaccine strain with sequence type 17532. The isolate was resistant to chloramphenicol, tetracycline, and cotrimoxazole. The patient clinically improved with the administration of combined intravenous ceftriaxone and levofloxacin antibiotics, along with chest tube drainage via thoracostomy. This is the first report of thoracic empyema caused by S. pneumoniae in an adult in Indonesia. Serotype 23F is multi-resistant with low invasiveness, typically causing infections in patients with underlying health conditions. The pneumococcal conjugate vaccine covers it; thus, it usually occurs in areas with low vaccine coverage. Our findings support the importance of improving adult pneumococcal vaccination coverage in Indonesia.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2025-12-23</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2902</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 57 No. 4 (2025): Acta Medica Indonesiana; 503</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2902/833</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2025 Indra Yovi, Aisyah Elliyanti, Dodi Safari, Nur Afrainin, Dewi Anggraini, Rosantia Sarassari, Yustinus Maladan, Ayummi Azzahrah, Nicholas Gilbert Pelawi</dc:rights>
	<dc:rights xml:lang="en-US">https://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>