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Unusual presentation of more common disease/injury
Case report
Asymptomatic man with an incidental finding of a massive empyema
  1. Kashvi Gupta1,
  2. Elena Stuewe2 and
  3. Marianne Barry2
  1. 1Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
  2. 2Department of Medicine, Division of Pulmonary and Critical Care Medicine, Tufts Medical Center, Boston, Massachusetts, USA
  1. Correspondence to Dr Kashvi Gupta; kashvig{at}umich.edu

Abstract

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.

  • empyema
  • medical management
  • cardiothoracic surgery

https://doi.org/10.1136/bcr-2020-237178

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    Footnotes

    • Contributors KG and ES co-wrote the paper. MB edited the paper. All authors contributed to preparing and refining the manuscript for publication.

    • 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.

    • Patient consent for publication Obtained.

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