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Rapidly-Developing Pleural Effusion: Explosive Pleuritis Caused by Group A Streptococcal Infection.
Haris Asif1, Mateus Fernandes1, Allen Gorbonos1
1Internal Medicine, Woodhull Medical Center, New York City, USA.
Cureus
|August 22, 2022
Summary
Explosive pleuritis, a rapid progression of parapneumonic effusion, can occur within 24 hours. Group A Streptococcus is a common cause, leading to severe complications and prolonged treatment.
Area of Science:
- Infectious Diseases
- Pulmonology
- Critical Care Medicine
Background:
- Community-acquired pneumonia (CAP) is a significant global cause of infectious disease mortality.
- Parapneumonic effusion (PPE) is a frequent complication of CAP, potentially progressing to empyema.
- Explosive pleuritis, characterized by rapid PPE progression within 24 hours, increases morbidity.
Observation:
- Group A Streptococcus (GAS) is a primary pathogen in PPE, associated with higher effusion rates.
- A case study details a 30-year-old female with asthma presenting with GAS-related explosive pleuritis.
- Initial symptoms included URI, followed by rapid onset of shortness of breath and pleuritic chest pain.
Findings:
- Chest X-ray revealed a large, new right-sided pleural effusion.
- Pleural fluid culture confirmed Group A Streptococcus as the causative agent.
- The patient required prolonged hospitalization, chest tube placement, and failed video-assisted thoracoscopic surgery (VATS).
Implications:
- This case underscores the rapid and severe progression of GAS-associated explosive pleuritis.
- Challenges in managing such aggressive infections are highlighted.
- Effective treatment strategies for explosive pleuritis remain critical in clinical practice.
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