A rare presentation of aspergillus infection as empyema thoracis.
A 57-year-old diabetic and hypertensive man presented with a short history of fever, dry cough and right side chest pain. A chest radiograph showed right pleural based homogenous shadow in middle and lower zones with obliteration of right costo-phrenic angle suggestive of right side effusion. Aspiration of pleural fluid revealed frank pus for which inter-costal tube drainage was performed. Due to persistence of empyema, the patient was subjected to thoracoscopy. Thoracoscopy showed multiloculated empyema. Thoracoscopic pleural biopsy and fluid showed septate fungal hyphae. Thoracotomy and parietal pleurectomy, with resection of part of right lower lobe, was carried out. Pleural fluid, pleural and lung tissue culture grew Aspergillus fumigatus. The patient showed good recovery with voriconazole after thoracotomy.
Department of Pulmonology, Critical Care and Sleep Medicine, Delhi Heart and Lung Institute 3 MM - II Panchkuian Road, New Delhi - 110 055, India.
Manoj K
MK
Goel
Deven
D
Juneja
Satinder K
SK
Jain
Saikiran
S
Chaudhuri
Ajay
A
Kumar