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Pleural empyema secondary to perforated diverticulosis due to biliary neoplasia infiltration
  1. Maria Teresa Dawid de Vera1,
  2. Juan Daniel Prieto Cuadra1,2,
  3. Dolores Domínguez Pinos3 and
  4. Isabel Hierro Martín1
  1. 1Unidad de Gestión Clínica (UGC) de Anatomía Patológica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Málaga, Spain
  2. 2SYNLAB Pathology, SYNLAB Global Diagnosis, Barcelona, Spain
  3. 3Department of Radiology, Hospital Universitario Virgen de la Victoria, Malaga, Spain
  1. Correspondence to Dr Juan Daniel Prieto Cuadra; dannielpriet{at}


A long-term female smoker presented to the emergency department with cough, greenish mucus and dyspnoea, without fever. The patient also reported abdominal pain and significant weight loss in recent months. Laboratory tests showed leucocytosis with neutrophilia, lactic acidosis and a faint left lower lobe consolidation on chest X-ray, for which she was admitted to the pneumology department and started on broad-spectrum antibiotherapy. After 3 days of clinical stability, the patient deteriorated rapidly, with worsening of analytical parameters and coma. The patient died a few hours later. Given the rapid and unexplained evolution of the disease, a clinical autopsy was requested, which revealed a left pleural empyema caused by perforated diverticula by neoplastic infiltration of biliary origin.

  • Empyema
  • Pancreas and biliary tract
  • Pathology
  • Pleural infection

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  • Contributors Term and conceptualisation—MTDdV, JDPC, DDP and IH. Methodology—JDPC and MTDdV. Investigation—JDPC and MTDdV. Writing (original draft preparation)—MTDdV. Writing (review and editing)—MTDdV, JDPC and DDP. Visualisation—MTDdV. Supervision—JDPC, DDP and IH. Project administration—IH. Funding acquisition—IH.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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