Acute Empyema due to Gemella morbillorum Following COVID-19 in an Otherwise Healthy Middle-Aged Man.

Acute empyema typically occurs in elderly or immunocompromised individuals, and its development in healthy, non-elderly adults is uncommon. We report a case of acute empyema caused by Gemella morbillorum following COVID-19 infection in a previously healthy man in his mid-40s. He developed persistent fever and cough after COVID-19, and left pleural effusion was detected 3 weeks later. Despite meropenem therapy, his symptoms persisted, prompting referral to our institution. Imaging showed multiloculated pleural effusion compatible with stage II empyema, and video-assisted thoracoscopic surgery was performed. G. morbillorum was isolated from intraoperative specimens, and he recovered uneventfully. This case highlights that even healthy, non-elderly individuals may develop significant bacterial superinfection after COVID-19. Clinicians should therefore consider secondary bacterial infections, including empyema, when persistent or recurrent symptoms occur following COVID-19.