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Empyema thoracis from an inhaled peanut.
Laura Linehan1, John Hinchion, Terence M O'Connor
1Department of Respiratory Medicine, Mercy University Hospital, Cork, Ireland.
BMJ Case Reports
|April 2, 2014
Summary
An inhaled peanut caused a chronic empyema in a 77-year-old man with sarcoidosis. Surgical decortication successfully treated the lung condition.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Diagnostic Imaging
Background:
- A 77-year-old male ex-smoker with pulmonary sarcoidosis presented with persistent cough and decreased breath sounds.
- Initial concerns included bronchogenic carcinoma due to symptoms and smoking history.
Observation:
- Chest X-ray revealed right pleural effusion and airspace opacification.
- Bronchoscopy identified a peanut obstructing the right lower lobe bronchus.
- CT scan showed a multiloculated pleural effusion and atelectasis, indicative of chronic empyema.
Findings:
- The patient underwent chest drain insertion, which was insufficient for complete fluid clearance.
- Thoracoscopic decortication was performed to address the pleural empyema secondary to bronchial obstruction by the inhaled peanut.
Implications:
- This case highlights the importance of considering foreign body aspiration in adults presenting with persistent respiratory symptoms and effusion.
- Successful surgical intervention (thoracoscopic decortication) resolved the chronic empyema and obstruction.
- Foreign body aspiration can lead to severe thoracic complications, even in elderly patients without a clear history of aspiration.
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