Trichomonas tenax empyema in an immunocompromised patient with advanced cancer.

A 53-year-old male acromegalic patient with advanced rectal adenocarcinoma developed pleuritis in the course of cobalt irradiation, steroid treatment and chemotherapy. Examination of drained pleural fluid demonstrated numerous motile organisms, which were identified as Trichomonas tenax by Giemsa staining. Peptostreptococcus micros was also detected in the cultures of pleural fluid and blood. Treatment with metronidazole successfully eliminated the protozoa and cured the pyothorax.