Spontaneous bacterial empyema is a spontaneous infection of the pleural cavity in the absence of pneumonia, typically seen in patients with liver cirrhosis and preexisting hepatic hydrothorax. Empyema thoracis caused by Escherichia coli (E. coli) is a rare clinical finding and, in most cases, a consequence of E. coli pneumonia. Spontaneous bacterial empyema secondary to E. coli in a non-cirrhotic individual is an unusual association, rarely described in the literature. To the best of our knowledge, this is the first case of spontaneous bacterial E. coli empyema thoracis in a non-cirrhotic, immunocompetent individual with a complex medical history including pulmonary thromboembolism, oropharyngeal dysphagia, and a high aspiration risk of oropharyngeal secretions.

Keywords: complex medical history; escherichia coli empyema; high aspiration risk; non-cirrhotic; oropharyngeal dysphagia; pulmonary thromboembolism; spontaneous bacterial empyema.