| Autor: |
Bapti Roy, Mark C. Teh, Yi Jin Kuok, Y. C. Gary Lee |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
|
| Zdroj: |
Respirology Case Reports, Vol 8, Iss 7, Pp n/a-n/a (2020) |
| Druh dokumentu: |
article |
| ISSN: |
2051-3380 |
| DOI: |
10.1002/rcr2.646 |
| Popis: |
Abstract Intrapleural tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) therapy is a new treatment for pleural infection. Clinical experiences of tPA/DNase therapy, and its complications, are cumulating. We present a patient with multiloculated empyema but no initial evidence of a bronchopleural fistula. She was treated with antibiotics and chest tube drainage of the basal collection through which four doses of tPA/DNase were delivered with success. The lateral collection worsened necessitating separate tube drainage and tPA/DNase treatment. She reported chest “fullness” when instilled the second dose. The third instillation of tPA triggered immediate vigorous coughing and expectoration of salty‐tasting fluid, likely the tPA/saline solution. The symptoms spontaneously settled after 15 min, with no evidence of air leak. The loculated fluid was successfully evacuated. The patient made a full recovery after an antibiotic course with no long‐term consequences. Pulmonary migration of drugs via a bronchopleural communication, although rare, can occur with intrapleural tPA/DNase therapy. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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