Open AccessTwo sequential tPA/DNase courses for noncommunicating loculated collections in pleural infection
Author(s) -
Popowicz Natalia,
Piccolo Francesco,
Shrestha Ranjan,
Lee Y. C. Gary
Publication year - 2014
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.58
Subject(s) - medicine , empyema , pleural fluid , tissue plasminogen activator , deoxyribonuclease , parapneumonic effusion , surgery , plasminogen activator , pleural empyema , pleural effusion , dna , biology , genetics
Intrapleural tissue plasminogen activator ( tPA ) and deoxyribonuclease ( DNase ) therapy is being increasingly employed as an alternative to surgical intervention for the treatment of complicated parapneumonic effusions and empyema. Published cases are limited to one randomized control trial and few case reports. No data exist on employing sequential or repeated courses of intrapleural tPA/DNase to aid evacuation of separate collections in patients' with a multiloculated pleural infection. This is the first report of successful use of sequential delivery of separate courses of intrapleural tPA/DNase to two noncommunicating infected pleural fluid collections within the same hemithorax of a patient. Our case confirms that prior treatment with tPA/DNase therapy does not preclude subsequent effective and safe use of this intrapleural treatment.