title: [Pleural effusion in hereditary haemorrhagic telangiectasia: hemothorax or empyema?].
abstract: BACKGROUND
  In hereditary hemorrhagic telangiectasia the pulmonary arteriovenous malformations frequently lead to complications. In a case of pleural effusion in a patient with known pulmonary arterio-venous malformations, the first diagnosis to consider is a hemothorax even though alternatives such as empyema are possible.
  
  
  METHODS
  We report the case of a 35-year-old woman with a known diagnosis of hereditary hemorrhagic telangiectasia with bilateral arteriovenous malformations, who was admitted to the emergency department with subacute dyspnoea and left thoracic pain. The clinical examination suggested a hemothorax. Pulmonary angiography was performed and showed an arteriovenous malformation in the left lower lobe. Embolisation was undertaken and at the same time a chest tube was inserted. Pus was evacuated leading to the final diagnosis of pleural empyema. Progress was good despite an episode acute respiratory distress due to a pulmonary embolism.
  
  
  CONCLUSIONS
  Pleural empyema is rarely described in the context of hereditary hemorrhagic telangiectasia with pulmonary arteriovenous malformations. In the case of pleural effusion this diagnosis should be considered even though hemothorax is more common.
authors.affiliation: Pôle de pathologie thoracique, service de pneumologie, nouvel hôpital civil, CHU de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France. tristan.degot@chru-strasbourg.fr
authors.forename: T
authors.initials: T
authors.lastname: Dégot
authors.forename: M
authors.initials: M
authors.lastname: Canuet
authors.forename: S
authors.initials: S
authors.lastname: Hirschi
authors.forename: N
authors.initials: N
authors.lastname: Santelmo
authors.forename: P E
authors.initials: PE
authors.lastname: Falcoz
authors.forename: F
authors.initials: F
authors.lastname: Boujan
authors.forename: R
authors.initials: R
authors.lastname: Kessler
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D016724:Empyema, Pleural / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006491:Hemothorax / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D010996:Pleural Effusion / Q000150:complications* / Q000175:diagnosis*; D013902:Radiography, Thoracic; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications* / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed