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Fungal pleural effusion secondary to a rare cause of pancreatic pseudocyst
Author(s) -
Gupta Atul,
Marrs Tom,
Urquhart Donald,
Clarke Simon,
Rosenthal Mark,
Bush Andrew
Publication year - 2009
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.20982
Subject(s) - medicine , pancreatic pseudocyst , pleural effusion , pancreatitis , effusion , surgery
We report a case of fungal pleural effusion secondary to presumed valproate induced pancreatitis with pseudocyst and stricture formation. A child with dyskinetic cerebral palsy who had been on sodium valproate for several years was transferred for drainage of a left sided pleural effusion. Pleural fluid culture consistently grew Candida glabrata although the patient was treated with broad‐spectrum antibiotic and antifungal therapy. Clinical deterioration ensued with abdominal discomfort, feed intolerance, and re‐accumulation of the effusion. Investigations revealed a large pancreatic pseudocyst compressing the stomach and impairing pancreatic function. Subsequent therapeutic evacuation of pancreatic fluid demonstrated C. glabrata . This case underscores that pleural disease may be secondary to abdominal pathology, and always to consider rare side‐effects of medication in the face of a puzzling clinical picture. Pediatr Pulmonol. 2009; 44:616–618. © 2009 Wiley‐Liss, Inc.