title: [Clinical analyses of fungal pleurisy: a report of 4 cases].
abstract: OBJECTIVE
  To explore the clinical features of fungal pleurisy.
  
  
  METHODS
  Four cases of fungal pleurisy diagnosed by medical thoracoscopy at Beijing Chaoyang Hospital from April 2005 to December 2012 were retrospectively studied.
  
  
  RESULTS
  There were 3 males and 1 female with an age range of 43-73 years. The time from initial onset to definite diagnosis was 17 days to 4 months. Among them, two were previously healthy while another two had underlying diseases. The diagnoses were mucor pleuritis (n = 1) and aspergillus (n = 3). There was one case of empyema. One case was diagnosed as non-Hodgkin lymphoma two years ago and had pleural metastasis during hospitalization. And another one suffered concurrently from diabetes mellitus and hypoproteinemia. The primary clinical manifestations included fever (n = 2), cough and sputum (n = 3), breathlessness (n = 4) and weight loss (n = 2). The major chest computed tomography (CT) scan revealed pleural effusion with thickening. All cases had an elevated plasma level of C-reactive protein (CRP). The characteristics of pleural effusion were empyema (n = 1) and exudates (n = 3). Pleural fluid smear and culture tests for bacteria and fungi were negative, so were pleural fluid smear tests for mycobacteria. All cases were confirmed through histopathological examination of pleural biopsies and cured after systemic antifungal therapy and pleural irrigation.
  
  
  CONCLUSIONS
  Fungal pleurisy is infrequent. Early thoracoscopy is vital because of a low positive yield of microbiologic testing of pleural fluid specimens. Systemic antifungal therapy and pleural irrigation improve the prognosis.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Institute of Respiratory Medicine, Beijing 100020, China.
authors.forename: Wenping
authors.initials: W
authors.lastname: Mao
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Institute of Respiratory Medicine, Beijing 100020, China.
authors.forename: Zhixin
authors.initials: Z
authors.lastname: Cao
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Institute of Respiratory Medicine, Beijing 100020, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Yang
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Institute of Respiratory Medicine, Beijing 100020, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Jiao
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Institute of Respiratory Medicine, Beijing 100020, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Xue
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Institute of Respiratory Medicine, Beijing 100020, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Institute of Respiratory Medicine, Beijing 100020, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Hang
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Institute of Respiratory Medicine, Beijing 100020, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Institute of Respiratory Medicine, Beijing 100020, China; Email: cyyyzlm@sina.com.
authors.forename: Liming
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D003371:Cough; D004417:Dyspnea; D005260:Female; D005334:Fever; D006801:Humans; D008228:Lymphoma, Non-Hodgkin; D008297:Male; D008875:Middle Aged; D010994:Pleura; D010996:Pleural Effusion; D010998:Pleurisy; D011379:Prognosis; D012189:Retrospective Studies; D013183:Sputum; D013906:Thoracoscopy; D013909:Thorax; D014057:Tomography, X-Ray Computed