Pei-Jun Li,1 Ming-Jing Yu,1 Dan Liu1– 3 

1Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China; 2Department of Institute of Respiratory Health, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China; 3Department of Precision Medicine Key Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China

Correspondence: Dan Liu, Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan, 610041, People’s Republic of China, Tel +86 18980605965, Email liudan10965@wchscu.cn

Background: Necrotizing pneumonia with subsequent bronchopleural fistula attributable to Streptococcus pneumoniae infection has not been reported in adults.
Case Presentation: We here firstly report a case of 23-year-old female with severe community-acquired multiple lung abscesses due to Streptococcus pneumoniae in the left lower lung, which merged and ruptured, further leading to the development of bronchopleural fistulas. After adequate anti-infective treatment and repairing the fistulas under thoracoscopy, the pulmonary infection was under control, and the fistulas were closed. A follow-up chest CT demonstrated the complete resolution of lung abscesses.
Conclusion: This case shows the possibility that necrotizing pneumonia due to Streptococcus pneumoniae infection can lead to bronchopleural fistula in adults. Early diagnosis and management of bronchopleural fistula are crucial for improving patients outcomes.

Keywords: Streptococcus pneumoniae, necrotizing pneumonia, lung abscess, bronchopleural fistula