[A case of empyema after pneumonectomy caused by methicillin-resistant staphylococcus aureus infection treated successfully with local administration with vancomycin].

A 55-year-old man underwent left pneumonectomy due to squamous cell carcinoma. Three weeks later bronchopleural fistula and pleural empyema with MRSA infection were recognized. Treatment was based on closed pleural drainage and antibiotic therapy. Initially patient was treated with trimethoprin-sulfamethoxazole and then vancomycin intravenously but empyema was not cured completely. Therefore repeated instillation of vancomycin into the empyema cavity was applied. After 6 days of treatment, culture studies of the pleural fluid became negative and drainage tube was removed 5 days later. We suggest that local administration of vancomycin is an effective method in postpneumonectomy empyema with MRSA infection.