Empyema in tension

Case contributed by Dr Jeremy Jones

Presentation

Cough and symptoms consistent with a chest infection. Reduced air entry on the right.

Patient Data

Age: 35 years
Gender: Male
X-ray

There is a large right sided effusion with underlying basal collapse. No mass lesion identified.

X-ray

24 hours later

Despite antibiotic therapy, the side of the pleural collection has increased in size. There is now mediastinal shift.

CT

The right hemithorax is filled with a huge pleural collection with the right lung compressed medially and consequent mediastinal shift. There is an enhancing rim around the collection.

Case Discussion

This pleural collection was confirmed to be an empyema at drainage where 5 litres of pus were drained from the chest. 

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Case information

rID: 24187
Case created: 31st Jul 2013
Last edited: 14th May 2016
System: Chest
Inclusion in quiz mode: Included

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