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Probiotic intake unmasking a gastro-pleural fistula
A Gallo1, L di Gialleonardo, F Lococo
1Unit of Internal Medicine, UOC Medicina Interna, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy. antonella.gallo@policlinicogemelli.it.
European Review for Medical and Pharmacological Sciences
|April 8, 2021
Summary
Gastropleural fistula, a rare complication of gastrointestinal surgery, can cause persistent pneumonia. Early diagnosis via probiotic bacteria detection in pleural fluid is key for timely surgical intervention and improved patient outcomes.
Area of Science:
- Gastroenterology and Pulmonology
- Surgical Complications
- Diagnostic Microbiology
Background:
- Gastropleural fistula is an uncommon complication, often iatrogenic following gastrointestinal surgery.
- Patients may present with insidious, chronic respiratory symptoms, initially mimicking lung infections.
Observation:
- A case of a healthy 51-year-old male with empyema due to an unexpected gastropleural fistula is presented.
- Initial treatment with antibiotics and pleural drainage was ineffective, prompting further investigation.
Findings:
- Identification of probiotic bacteria in pleural fluid led to the suspicion of a gastropleural fistula.
- CT-scan and digestive endoscopy confirmed the fistula, necessitating combined thoraco-abdominal surgical treatment.
Implications:
- Gastropleural fistula should be considered in the differential diagnosis of complicated pneumonia.
- Early diagnosis and surgical management are crucial for improving patient prognosis.
- Detection of specific bacteria in pleural fluid can aid in suspecting this rare condition.
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