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Papazachariou A, Papadokostaki E, Kypraiou D, Malikides V, Papakitsou I, Filippatos TD, Ioannou P, Kofteridis DP. Hydropneumothorax as a complication of necrotizing pneumonia. Germs 2023; 13:332-337. [PMID: 38361549 PMCID: PMC10866169 DOI: 10.18683/germs.2023.1402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 02/17/2024]
Abstract
Introduction Hydropneumothorax with a bronchopleural fistula is an infrequent but severe complication of necrotizing pneumonia associated with high morbidity and mortality. Few cases in the adult population have been reported. Case report This is a case of a 76-year-old male patient who developed pneumonia caused by Pseudomonas aeruginosa and Klebsiella pneumoniae complicated by hydropneumothorax. He was managed conservatively with chest tube placement but denied surgical management and eventually died despite initial improvement. Conclusions Early recognition and appropriate management of pneumonia complications, such as hydropneumothorax, including thoracic surgeon interventions, are crucial as this complication can be fatal. Factors like the patient's overall status, preferences, and comorbidities may have a crucial effect on clinical decisions and outcomes.
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Affiliation(s)
- Andria Papazachariou
- MD, Internal Medicine Department, University Hospital of Heraklion, Heraklion, Greece, PC 71110
| | - Eleni Papadokostaki
- MD, Internal Medicine Department, University Hospital of Heraklion, Heraklion, Greece, PC 71110
| | - Despoina Kypraiou
- MD, Internal Medicine Department, University Hospital of Heraklion, Heraklion, Greece, PC 71110
| | - Vironas Malikides
- MD, Internal Medicine Department, University Hospital of Heraklion, Heraklion, Greece, PC 71110
| | - Ioanna Papakitsou
- MD, Internal Medicine Department, University Hospital of Heraklion, Heraklion, Greece, PC 71110
| | - Theodosios D Filippatos
- MD, PhD Internal Medicine Department, University Hospital of Heraklion, Heraklion, Greece, PC 71110, and School of Medicine, University of Crete, Heraklion, Greece, PC 71003
| | - Petros Ioannou
- MD, MSc, PhD Internal Medicine Department, University Hospital of Heraklion, Heraklion, Greece, PC 71110, and School of Medicine, University of Crete, Heraklion, Greece, PC 71003
| | - Diamantis P Kofteridis
- MD, PhD Internal Medicine Department, University Hospital of Heraklion, Heraklion, Greece, PC 71110, and School of Medicine, University of Crete, Heraklion, Greece, PC 71003
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Bathobakae L, Shahid A, Wilkinson T, Adalja D, Sanchez J, Agnelli M, Suh J, Solis R. Tuberculous Bronchopleural Fistula: A Rare and Life-Threatening Disease. J Investig Med High Impact Case Rep 2023; 11:23247096231220466. [PMID: 38130119 DOI: 10.1177/23247096231220466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Tuberculous bronchopleural fistula (BPF) is a rare and potentially life-threatening complication of pulmonary tuberculosis, in which abnormal connections form between the bronchial tree and the pleural space. These abnormal connections allow air and secretions to pass from the lungs into the pleural space, causing a range of symptoms from benign cough to acute tension pneumothorax. The management of tuberculous BPF requires an individualized approach based on the patient's condition and response to treatment. Anti-tuberculosis therapy is essential for controlling the active tuberculosis infections. Intercostal drainage and suction are also commonly used to drain air and fluid from the pleural space, providing relief from the symptoms. For some patients, more invasive surgeries, such as decortication, thoracoplasty or pleuropneumonectomy are required to definitively close the fistula when medical management alone is insufficient. Herein, we describe a rare case of tuberculous BPF in a young adult female, who was treated with anti-tuberculosis medications and open thoracotomy.
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Affiliation(s)
| | - Aneeqa Shahid
- St. Joseph's University Medical Center, Paterson, NJ, USA
| | | | - Devina Adalja
- St. Joseph's University Medical Center, Paterson, NJ, USA
| | | | | | - Jin Suh
- St. Joseph's University Medical Center, Paterson, NJ, USA
| | - Roberto Solis
- St. Joseph's University Medical Center, Paterson, NJ, USA
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