Presentation
5 day history of productive coughing, shortness of breath, subjective fevers and left-sided chest pain.
Patient Data
Large left sided pleural effusion with complete atelectasis of the left lower lobe and positive mass effect. There is occlusion of the left lower lobe bronchus. Split pleura sign in keeping with pleural enhancement involving the costal and mediastinal pleural surfaces.
Minor scattered atelectatic changes in the right lower lobe.
No significant mediastinal adenopathy. No convincing sign of pulmonary abscess.
Case Discussion
This case illustrates a significant left-sided empyema secondary to aspiration pneumonia.
A left intercostal catheter was inserted and intrapleural fibrinolysis was performed. The patient underwent video-assisted thoracoscopic surgery. Intra-operatively, two large posterior locations were drained.
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