Surgical treatment of acute empyema caused by methicillin-resistant Staphylococcus aureus in a patient with advanced non-small cell lung cancer: a case report.

A 75-year-old man presented to our hospital with fever and bloody sputum. Chest computed tomography revealed a mass lesion occupying the left lower lobe with surrounding infiltrative shadows. 18F-fluoro-2-deoxy-glucose positron emission tomography demonstrated high 18F-fluoro-2-deoxy-glucose uptake in the pulmonary mass, left hilar lymph nodes, and right mediastinal lymph node. Transbronchial biopsy confirmed squamous cell carcinoma. The patient was diagnosed with clinical stage IIIC non-small cell lung cancer, and chemoradiotherapy was planned. However, 21 days after the biopsy, he developed acute empyema. Decortication was successfully performed by video-assisted thoracic surgery. Postoperatively, the antimicrobial agent was switched from meropenem hydrate to linezolid after methicillin-resistant Staphylococcus aureus was detected in the pleural effusion culture. The chest tubes were removed 7 days after surgery, and the patient was discharged 1 month after surgery. Chest computed tomography at 1.5 months postoperatively showed no recurrence of empyema, and chemotherapy for advanced non-small cell lung cancer was initiated.