Open AccessAsymptomatic man with an incidental finding of a massive empyema
Author(s) -
Kashvi Gupta,
Elena Stuewe,
Marianne Barry
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-237178
Subject(s) - medicine , empyema , decortication , thoracentesis , asymptomatic , parapneumonic effusion , surgery , pleural disease , pneumonia , pleural effusion , cardiothoracic surgery , pleural empyema , pleural fluid , respiratory disease , lung
We describe the case of a 67-year-old asymptomatic man who was referred to our hospital for abnormal laboratory results. He was incidentally found to have a massive empyema without underlying bronchopulmonary pneumonia. Following thoracentesis, he was diagnosed with chronic Streptococcus anginosus empyema. Therapeutic thoracentesis and treatment with tissue plasminogen activator and deoxyribonuclease failed to resolve the empyema, and there was residual loculated pleural fluid that was surrounded by a thick rind. The patient was referred to thoracic surgery for decortication of the pleural space via video-assisted thoracoscopic surgery. At 2-month follow-up, the patient had complete re-expansion of the lung tissue.