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pleural fluid

Evaggelina Papakanderaki, Konstantinos Kanakakis, Sotirios Goule, Maria Chounti, Panagiotis Hountis
Raoultella Ornithinolytica (RO) is an encapsulated, Gram- negative, nonmotile aerobic rob which was reclassified from Klepsiella genus belonging in the family of Enterobacteriaceae. It is a rare human infection and few cases have been reported in post thoracotomy patients. Here we present a case of a left lower lobectomy patient that was complicated by pleural effusion and high fever with positive sputum cultures of Raoultella Ornithinolytica and positive pleural fluid cultures of Staphylococcus hominis. It is related with aquatic life poisoning...
February 26, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Justin K Lui, Lidia Spaho, Erik Holzwanger, Rosa Bui, Jennifer S Daly, Adel Bozorgzadeh, Scott E Kopec
Chronic liver disease has been associated with pulmonary dysfunction both before and after liver transplantation. Post-liver transplantation pulmonary complications can affect both morbidity and mortality often necessitating intensive care during the immediate postoperative period. The major pulmonary complications include pneumonia, pleural effusions, pulmonary edema, and atelectasis. Poor clinical outcomes have been known to be associated with age, severity of liver dysfunction, and preexisting lung disease as well as perioperative events related to fluid balance, particularly transfusion and fluid volumes...
January 1, 2018: Journal of Intensive Care Medicine
Muhammad Saeed, Farhan Rasheed, Shagufta Iram, Shahida Hussain, Adeel Ahmad, Saba Riaz, Maqsood Ahmad
OBJECTIVE: To evaluate the false negative results of Ziehl-Neelsen (ZN) smear microscopy. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Mycobacteriology Laboratory, Allama Iqbal Medical College (AIMC) and Jinnah Hospital, Lahore (JHL), Pakistan, from February 2014 to August 2016. METHODOLOGY: A total of 3,951 (pulmonary 2,773 and extra-pulmonary 1,178) samples were collected from strong TB suspected patients attending JHL Lahore...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Ashraf Abugroun, Marion Gonzalez, Daniel Vilchez
Renal artery stenosis (RAS) is the leading cause of secondary hypertension. Renal artery stenosis can result in various cardiopulmonary complications mostly through activation of neurohormonal pathways that result in fluid overload and systemic hypertension. We herein describe a 72-year-old man with recurrent rapidly accumulating transudative pleural effusion in a patient with severe bilateral RAS. Patient pleural effusion resolved following stent placement with revascularization of the left renal artery despite absence of improvement of renal function...
2018: Clinical Medicine Insights. Case Reports
Duneesha de Fonseka, Nick A Maskell
PURPOSE OF REVIEW: Pleural infection is a common problem associated with significant morbidity and mortality. Systemic or pleural fluid markers for reliably identifying pleural infection are limited. Procalcitonin (PCT) is known to be elevated in bacterial infection and is currently used for diagnosis and decision-making regarding antibiotic duration in respiratory infections. This review investigates if there is a role for serum and pleural fluid PCT (pf-PCT) in diagnosis and management of pleural infection...
March 9, 2018: Current Opinion in Pulmonary Medicine
Vasileios S Skouras, Ioannis Kalomenidis
PURPOSE OF REVIEW: To summarize data regarding categories, detection methods, prevalence and patterns of drug resistance among patients with tuberculous pleural effusion (TPE) and to comment on the management of suspected drug-resistant TPE. RECENT FINDINGS: Pleural and pulmonary tuberculosis (TB) present similar patterns of drug resistance. Approximately 10% and 6-10% of pleural Mycobacterium tuberculosis isolates are resistant to at least one first-line anti-TB drug or at least isoniazid, respectively...
March 9, 2018: Current Opinion in Pulmonary Medicine
Sibel Kara, Nazan Sen, Sule Akcay, Gokhan Moray, Murat Kus, Mehmet Haberal
Hydrothorax occurs frequently in patients with endstage liver disease and usually requires drainage of pulmonary effusion during the hepatectomy phase of liver transplant. Reexpansion pulmonary edema is a rare but potentially fatal complication seen after rapid reexpansion of the collapsed lung following thoracentesis of pleural fluid or tube drainage of pneumothorax. This condition, which manifests with various degrees of clinical severity, is rarely reported following liver transplantation. Herein, we present a 62-year-old male patient who developed reexpansion pulmonary edema after drainage of massive pleural effusion, which caused a total collapse in the right hemithorax during liver transplant...
March 2018: Experimental and Clinical Transplantation
Ioannis Psallidas, Nikolaos I Kanellakis, Rahul Bhatnagar, Rahul Ravindran, Ahmed Yousuf, Anthony J Edey, Rachel M Mercer, John P Corcoran, Robert J Hallifax, Rachelle Asciak, Prashanth Shetty, Tao Dong, Hania E G Piotrowska, Colin Clelland, Nick A Maskell, Najib M Rahman
BACKGROUND: Pleural infection is a common complication of pneumonia associated with high mortality and poor clinical outcome. Treatment of pleural infection relies on the use of broad-spectrum antibiotics, since reliable pathogen identification occurs infrequently. We performed a feasibility interventional clinical study assessing the safety and significance of ultrasound (US)-guided pleural biopsy culture to increase microbiological yield. In an exploratory investigation, the 16S rRNA technique was applied to assess its utility on increasing speed and accuracy versus standard microbiological diagnosis...
March 7, 2018: Chest
José M Porcel
PURPOSE OF REVIEW: To provide an overview of the contribution of thoracic ultrasound (TUS) and computed tomography (CT) in the identification of complicated parapneumonic effusions (CPPE), defined as those which need chest tube drainage for resolution. RECENT FINDINGS: A recent retrospective study found that visualization of complex (nonanechoic) effusions on TUS (likelihood ratio positive = 6.92) outperformed the recognition of loculated/septated effusions on CT (likelihood ratio = 2...
March 6, 2018: Current Opinion in Pulmonary Medicine
John P Lichtenberger, Andrew M Kim, Dane Fisher, Peter S Tatum, Brian Neubauer, P Gabriel Peterson, Brett W Carter
Introduction: Combat-related thoracic trauma is a significant contributor to morbidity and mortality of the casualties from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Penetrating, blunt, and blast injuries were the most common mechanisms of trauma. Imaging plays a key role in the management of combat-related thoracic trauma casualties. This review discusses the imaging manifestations of thoracic injuries from penetrating trauma, emphasizing epidemiology and diagnostic clues seen during OEF and OIF...
March 1, 2018: Military Medicine
Samanta Sarmento da Silva, Guilherme Eckert Peterson, Sérgio Luis Amantéa, Patrícia Miorelli, Jane Maria Ulbrich, Eliane Roesch, Paulo Roberto Sanches, Jose Carlos Fraga
PURPOSE: To evaluate the concentration of transforming growth factor beta 1 (TGFB1) levels in a rat pleural effusion obtained by inoculation of intrapleural bacteria or turpentine through thoracentesis. METHODS: Thirty-Nine Wistar rats were divided into three groups: Staphylococcus aureus (SA, n = 17); Streptococcus pneumoniae (SP, n = 12); and turpentine (control, n = 10). Pleural fluid was collected through ultrasound-guided thoracentesis 12 h, 24 h, and 36 h after instillation of bacteria or turpentine...
February 2018: Acta Cirúrgica Brasileira
Luca Luzzi, Federico Franchi, Annarita Dapoto, Marco Ghisalberti, Roberto Corzani, Daniele Marrelli, Luca Marchetti, Piero Paladini, Sabino Scolletta
Background: In the treatment of malignant pleural mesothelioma the Hyperthermic Intra THOracic Chemotherapy (HITHOC) can improve the efficacy of pleurectomy and decortication with a local cytotoxic effect. However its biological impact in patient's hemodynamic and microcirculatory changes were rarely investigated. Aim of this study is to describe our experience with HITHOC after pleurectomy and decortication evaluating the role of sublingual video-microscopy in assessing the microcirculatory changes in the perioperative period...
January 2018: Journal of Thoracic Disease
Natalia D Popowicz, Sean J O'Halloran, Deirdre Fitzgerald, Y C Gary Lee, David A Joyce
Piperacillin, in combination with tazobactam is a common first-line antibiotic used for the treatment of pleural infection, however its pleural pharmacokinetics and penetration has not previously been reported. The objective of this work was to develop and validate a rapid and sensitive liquid chromatography with tandem mass spectrometry (LC-MS/MS) assay for quantification of piperacillin (PIP) and tazobactam (TAZ). PIP and TAZ were extracted from both human plasma and pleural fluid samples by protein precipitation in methanol containing the internal standards (IS) piperacillin-d5 (PIP-d5 ) and sulbactam (SUL)...
February 24, 2018: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
Xiao Zhang, Yi Sun, Caiyun He, Xiaofen Qiu, Dalei Zhou, Zulu Ye, Yakang Long, Tao Tang, Xuan Su, Jiangjun Ma
We aimed to assess the immunoregulatory effects of IFN-β in patients with tuberculous pleurisy. IFN-β, IFN-γ and IL-17 expression levels were detected, and correlations among these factors in different culture groups were analyzed. Pleural fluid mononuclear cells (PFMCs) from tuberculous pleural effusions, but not peripheral blood mononuclear cells (PBMCs) from healthy donors, spontaneously expressed IFN-β, IL-17 and IFN-γ. Moreover, exogenous IFN-β significantly inhibited the expression of IL-17 in PFMCs...
March 5, 2018: Microbiology and Immunology
Yusuke Kameda, Akira Hirose, Tomohiro Iida, Yasuko Uchigata, Shigehiko Kitano
Purpose: To report a case of a giant retinal pigment epithelial (RPE) tear associated with fluid overload in a patient with diabetic macular edema (DME) and kidney disease. Observations: A 60-year-old man with type 2 diabetes mellitus and end-stage diabetic kidney disease who had gained weight because of fluid overload complained of a visual disturbance in the left eye that had started a few days earlier. The left fundus showed a RPE defect in two temporal quadrants under an extensive serous retinal detachment (SRD) with exacerbation of the original DME...
April 2017: American Journal of Ophthalmology Case Reports
James A Stefater, Dean Eliott, Leo A Kim
Purpose: To describe a case of a patient with acute systemic lupus erythematous (SLE) causing choroidal effusions and to report a novel technique for evaluation of the choroidal fluid which sheds light on effusion pathogenesis. Observations: A 37 year-old woman was referred for decreased vision, eye pain and shortness of breath. The patient had bilateral angle closure glaucoma from choroidal effusions and bilateral pleural effusions. Work-up revealed new onset acute SLE...
April 2017: American Journal of Ophthalmology Case Reports
A Kienlen, C Fernandez, Z Henni-Laleg, M Andre, V Gazaille, N Coolen-Allou
Thoracic endometriosis is a rare entity characterized by presence of endometrial tissue in pleura, lung parenchyma or airways. Most frequent manifestations are catamenial pneumothorax, hemothorax, hemoptysis and pulmonary nodules. We report here a rare case of a woman with thoracic endometriosis who developed iterative pneumothorax and pneumopericardium on bilateral bullous pulmonary dystrophy. She was a 37-year-old woman without any tobacco exposure and with previous history of pleural tuberculosis treated 5 years earlier...
March 1, 2018: Revue de Pneumologie Clinique
Monika Zielinska-Krawczyk, Rafal Krenke, Elzbieta M Grabczak, Richard W Light
Subatmospheric pleural pressure (Ppl), which is approximately -3 to -5 cmH2 O at functional residual capacity (FRC) makes pleura a unique organ in the human body. The negative Ppl is critical for maintaining the lungs in a properly inflated state and for proper blood circulation within the thorax. Significant and sudden pleural pressure changes associated with major pleural pathologies, as well as therapeutic interventions may be associated with life-threatening complications. The pleural pressure may show two different values depending on the measurement method applied...
March 2018: Respiratory Medicine
Silvia M S Sandes, Luana Heimfarth, Renan G Brito, Priscila L Santos, Daniele N Gouveia, Alexandra M S Carvalho, Jullyana S S Quintans, Edeildo F da Silva-Júnior, Thiago M de Aquino, Paulo H B França, João X de Araújo-Júnior, Ricardo L C Albuquerque-Júnior, Gokhan Zengin, Martine Schmitt, Jean-Jacques Bourguignon, Lucindo J Quintans-Júnior
BACKGROUND: Indole-3-guanylhydrazone hydrochloride (LQM01) is a new derivative of aminoguanidine hydrochloride, an aromatic aminoguanidine. METHODS: Mice were treated with LQM01 (5, 10, 25 or 50 mg/kg, i.p.), vehicle (0.9% saline i.p.) or a standard drug. The mice were subjected to carrageenan-induced pleurisy, abdominal writhing induced by acetic acid, the formalin test and the hot-plate test. The model of non-inflammatory chronic muscle pain induced by saline acid was also used...
February 27, 2018: Chemico-biological Interactions
Gathsaurie Neelika Malavige, Ananda Wijewickrama, Samitha Fernando, Chandima Jeewandara, Anushka Ginneliya, Supun Samarasekara, Praveen Madushanka, Chameera Punchihewa, Shiran Paranavitane, Damayanthi Idampitiya, Chandanie Wanigatunga, Harsha Dissanayake, Shamini Prathapan, Laksiri Gomes, Siti A B Aman, Ashley St John, Graham S Ogg
Currently there are no specific treatments available for acute dengue infection. We considered that rupatadine, a platelet-activating factor receptor inhibitor, might modulate dengue-associated vascular leak. The effects of rupatadine were assessed in vitro, and in a dengue model, which showed that rupatadine significantly reduced endothelial permeability by dengue sera in vitro, and significantly inhibited the increased haematocrit in dengue-infected mice with dose-dependency. We conducted a randomised, placebo-controlled trial in 183 adult patients in Sri Lanka with acute dengue, which showed that rupatadine up to 40 mg daily appeared safe and well-tolerated with similar proportions of adverse events with rupatadine and placebo...
March 1, 2018: Scientific Reports
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