Enterococcal-associated respiratory tract infection in dermatomyositis

This is to report a rare case of enterococcal pneumonia and pleural effusion in a 32-year old woman with severe and active dermatomyositis. She developed fever, respiratory failure, and pleuritic chest pain for 12 days before admission to our hospital. Chest X-ray showed increased overall density of the right hemithorax, indicative of pleural effusion and consolidation with air bronchogram. Cultured pleural drainage revealed growth of Enterococcus faecalis. The patient was treated with imipenem and intravenous immunoglobulin (IVIG) and corticosteroid and the patient’s response to treatment was very good. Chest radiography and chest (computed tomography) CT scan after treatment was quite clear. Enterococci rarely cause pneumonia and plural effusion in general population but it can be concluded that in patients with inflammatory myopathic disease who are treated with immunosuppressive drugs may be a factor of respiratory tract infection.