TY - JOUR T1 - Pleural empyema secondary to perforated diverticulosis due to biliary neoplasia infiltration JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2022-250061 VL - 16 IS - 3 SP - e250061 AU - Maria Teresa Dawid de Vera AU - Juan Daniel Prieto Cuadra AU - Dolores Domínguez Pinos AU - Isabel Hierro Martín Y1 - 2023/03/01 UR - http://casereports.bmj.com/content/16/3/e250061.abstract N2 - 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. ER -