Related Experiment Videos
[Infection of a pneumonectomy site 16 years after intervention]
L Hocqueloux1, F Le Pimpec Barthes, O Sanchez
1Clinique des Maladies infectieuses, Hôpital Saint-Louis, 1, avenue Claude Vellefaux, F 75010 Paris. emmahocq@club-internet.fr
Background:
Infection of the residual cavity after pneumonectomy generally occurs early after surgery.
Case Report:
A 67-year old patient was hospitalized with fever 16 years after pneumonectomy for lung cancer. Investigations led to the diagnosis of infection of the pneumonectomy cavity.
Discussion:
Late infection several years after pneumonectomy is exceptional and usually occurs in a setting of bacteriemia. Diagnosis is difficult due to modifications of the thoracic signs but should be entertained whenever unexplained fever or an inflammatory syndrome occurs in a pneumonectomized patient. The thoracic CT scan shows an abnormally enlarged cavity. Bacteriological examination of evacuated fluid provides the key to diagnosis. Drainage-lavage is indicated. Surgery may be needed exceptionally.
Insights
Late infection of the pneumonectomy cavity is rare, occurring years after surgery. Diagnosis requires vigilance for unexplained fever in patients with a history of pneumonectomy.
Area of Science:
- Thoracic Surgery
- Infectious Diseases
- Pulmonology
Background:
- Pneumonectomy, a surgical removal of a lung, can lead to residual cavity infections.
- These infections typically manifest early in the postoperative period.
Observation:
- A 67-year-old patient presented with fever 16 years post-pneumonectomy for lung cancer.
- Clinical presentation and investigations confirmed a late-onset infection of the pneumonectomy cavity.
Findings:
- Late-onset pneumonectomy cavity infection is an exceptional clinical event.
- Diagnosis is challenging due to altered thoracic signs but consider in patients with unexplained fever or inflammatory syndrome.
- Thoracic CT scans reveal an enlarged cavity; bacteriological fluid analysis is crucial for diagnosis.
Implications:
- Early recognition and prompt management, including drainage-lavage, are vital.
- While rare, late infections necessitate a high index of suspicion in post-pneumonectomy patients.
- Surgical intervention is reserved for exceptional, refractory cases.