A Unique Case of Conservatively Treated Actinomyces Empyema Complicated Due to Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome

This case contemplates the unusual presentation, challenging diagnostic workup and conservative therapeutic process of a patient with Actinomyces empyema complicated along way due to drug reaction eosinophilia systemic symptoms (DRESS) syndrome. The was 40-year-old male, who presented pleurodynia fever. Laboratory exams showed elevated inflammatory markers imaging revealed two biconvex fluid pockets located in right lower lobe, from which positive for meyeri. initial intravenous antibiotics successful drainage intrapleural fibrinolysis improved our patient. However, after few days, patient’s fevers relapsed, as regress discussed complication, he developed maculopapular symmetrical rash trunk legs accompanied by enlarged lymph nodes, eosinophilia, thrombocytopenia, atypical lymphocytes. diagnosis DRESS syndrome antibiotic therapy actinomyces established balance between bactericidal immunosuppression medication had be found. Fortunately, withstood prolonged got fully treated without any relapses.