| Title | [Diagnosis and treatment of parapneumonic effusions--case 10/2009] | | Author(s) | Hetzel J, Horger M, Spengler W, Aebert H, Kanz L, Müssig K | | Institution | Abteilung für Onkologie, Hämatologie, Klinische Immunologie, Rheumatologie und Pulmologie, Medizinische Universitätsklinik Tübingen. juergen.hetzel@med.uni-tuebingen.de | | Source | Dtsch Med Wochenschr 2009 Nov; 134(46):2341. | | Abstract | HISTORY AND ADMISSION
FINDINGS: We report on a 47-year-old male patient who was admitted for exercise-induced dyspnea and easy fatigability. Physical examination revealed reduced breath and percussion sounds of the left basal lung.
INVESTIGATIONS: Laboratory investigations revealed leucocytosis and elevated C-reactive protein levels. Chest X-ray showed an area of increased opacity of the left lower hemithorax. Computed tomography (CT) confirmed an encapsulated, septated pleural effusion. The aspirate was purulent with abundant neutrophil granulocytes and a pH value of 7.1.
DIAGNOSIS, TREATMENT AND COURSE: A diagnosis of left-sided pleural empyema was made, most probably following pneumonia. Antibiotic treatment with amoxicillin and clavulan acid was initiated and after insertion of a chest drain pleural irrigation with daily 200,000 I.U. streptokinase was performed for five days. The drainage was removed after ten days and after four months CT showed a complete remission of the lef-sided pleural empyema.
CONCLUSIONS: Parapneumonic effusions are frequent with broad clinical range from trivial to life-threatening. Therapy decision is based on the characteristics of the effusion and the patient's clinical status and should be made within an interdisciplinary cooperation between internists and (thoracic) surgeons. | | Language | ger | | Pub Type(s) | English Abstract
Journal Article
| | PubMed ID | 19894201 |
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