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CASE REPORT
Hepatic hydrothorax: indwelling catheter-related Acinetobacter radioresistens infection
  1. Cristiano Silva Cruz,
  2. Valentina Tosatto,
  3. Paula Oliveira Nascimento and
  4. Rita Barata Moura
  1. Department of Internal Medicine, Centro Hospitalar de Lisboa Central, EPE – Hospital de Santa Marta, Lisboa, Portugal
  1. Correspondence to Dr Paula Oliveira Nascimento, med.paulaoliveira{at}gmail.com

Abstract

Hepatic hydrothorax, a rare and debilitating complication of cirrhosis, carries high morbidity and mortality. First-line treatment consists of dietary sodium restriction and diuretic therapy. Some patients, mainly those who are refractory to medical management, will require invasive pleural drainage. The authors report the case of a 76-year-old man in a late cirrhotic stage of alcoholic chronic liver disease, presenting with recurrent right-sided hepatic hydrothorax, portal hypertension, hepatosplenomegaly and thrombocytopaenia. After recurrent admissions and complications, the potential for adjusting diuretic therapy was limited. After unsuccessful talc pleurodesis, an indwelling tunnelled pleural catheter was placed with effective symptomatic control. One month later, the patient was readmitted with empyema due to Acinetobacter radioresistens. Despite optimised medical and surgical treatment, the patient died 4 weeks later.

  • alcoholic liver disease
  • cirrhosis
  • pleural infection
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Footnotes

  • Contributors All authors were attending physicians involved on the management of the patient our ward. CSC, VT and PON: drafting of the manuscript. RBM: revised critically the manuscript for its design and important intellectual content. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Next of kin consent obtained.

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