title: Simple Pneumonia or Something More?: A Case Report and Discussion of Unexpected Empyema Identified by Point-of-Care Ultrasound.
abstract: There is evidence to suggest that point-of-care ultrasound assessment of the lungs has a higher sensitivity and specificity than chest radiography for the diagnosis of pneumonia. It is unknown if the same is true for pneumonia complications. We present and discuss the case of a 61-year-old woman who presented to the emergency department with confusion, decreased level of consciousness, and signs of sepsis. A chest x-ray revealed a right sided infiltrate. An ultrasound of the patient's lungs was performed, and revealed a complex loculated fluid collection consistent with an empyema. A chest CT confirmed the diagnosis, and immediate percutaneous drainage was performed.
authors.affiliation: *University of Toronto,Toronto,ON.
authors.forename: Michael
authors.initials: M
authors.lastname: Romano
authors.affiliation: †Sunnybrook Health Sciences Centre,Toronto,ON.
authors.forename: Tomislav
authors.initials: T
authors.lastname: Jelic
authors.affiliation: *University of Toronto,Toronto,ON.
authors.forename: Jordan
authors.initials: J
authors.lastname: Chenkin
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016638:Critical Illness; D003937:Diagnosis, Differential; D004322:Drainage / Q000379:methods; D004636:Emergency Service, Hospital; D004653:Empyema / Q000000981:diagnostic imaging* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011014:Pneumonia / Q000000981:diagnostic imaging* / Q000628:therapy; D019095:Point-of-Care Systems; D013902:Radiography, Thoracic / Q000379:methods; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents
keywords: PoCUS; emphyema; lung ultrasound