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Empyema Tube or No Tube?

We report the case of a 36-year-old man with cirrhosis who presented with recurrent infection of his right-sided hepatic hydrothorax in the form of fever, dyspnea, and cough. The pleural fluid analysis showed transudative fluid with normal pH, lactic acid dehydrogenase, and glucose, but with Escheri...

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Detalles Bibliográficos
Autores principales: Magendiran, Bhoobalan, Viswanathan, Stalin, Selvaraj, Jayachandran, Pillai, Vivekanandan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899129/
https://www.ncbi.nlm.nih.gov/pubmed/33633873
http://dx.doi.org/10.7759/cureus.12829
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author Magendiran, Bhoobalan
Viswanathan, Stalin
Selvaraj, Jayachandran
Pillai, Vivekanandan
author_facet Magendiran, Bhoobalan
Viswanathan, Stalin
Selvaraj, Jayachandran
Pillai, Vivekanandan
author_sort Magendiran, Bhoobalan
collection PubMed
description We report the case of a 36-year-old man with cirrhosis who presented with recurrent infection of his right-sided hepatic hydrothorax in the form of fever, dyspnea, and cough. The pleural fluid analysis showed transudative fluid with normal pH, lactic acid dehydrogenase, and glucose, but with Escherichia coli growth. An uncommon diagnosis of high mortality, spontaneous bacterial empyema was made. Criteria for chest tube drainage were met, but he was managed without one. He developed hospital-acquired pneumonia during his stay, but his pleural fluid showed the same characteristics. His empyema and pneumonia were managed with antibiotics and other supportive measures. On follow-up, he was readmitted on three other occasions with similar complaints and succumbed to upper gastrointestinal bleed during the fifth admission. A chest tube is not indicated in patients with spontaneous bacterial empyema unless frank pus is present.
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spelling pubmed-78991292021-02-24 Empyema Tube or No Tube? Magendiran, Bhoobalan Viswanathan, Stalin Selvaraj, Jayachandran Pillai, Vivekanandan Cureus Internal Medicine We report the case of a 36-year-old man with cirrhosis who presented with recurrent infection of his right-sided hepatic hydrothorax in the form of fever, dyspnea, and cough. The pleural fluid analysis showed transudative fluid with normal pH, lactic acid dehydrogenase, and glucose, but with Escherichia coli growth. An uncommon diagnosis of high mortality, spontaneous bacterial empyema was made. Criteria for chest tube drainage were met, but he was managed without one. He developed hospital-acquired pneumonia during his stay, but his pleural fluid showed the same characteristics. His empyema and pneumonia were managed with antibiotics and other supportive measures. On follow-up, he was readmitted on three other occasions with similar complaints and succumbed to upper gastrointestinal bleed during the fifth admission. A chest tube is not indicated in patients with spontaneous bacterial empyema unless frank pus is present. Cureus 2021-01-20 /pmc/articles/PMC7899129/ /pubmed/33633873 http://dx.doi.org/10.7759/cureus.12829 Text en Copyright © 2021, Magendiran et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Magendiran, Bhoobalan
Viswanathan, Stalin
Selvaraj, Jayachandran
Pillai, Vivekanandan
Empyema Tube or No Tube?
title Empyema Tube or No Tube?
title_full Empyema Tube or No Tube?
title_fullStr Empyema Tube or No Tube?
title_full_unstemmed Empyema Tube or No Tube?
title_short Empyema Tube or No Tube?
title_sort empyema tube or no tube?
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899129/
https://www.ncbi.nlm.nih.gov/pubmed/33633873
http://dx.doi.org/10.7759/cureus.12829
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