Simple Pneumonia or Something More?: A Case Report and Discussion of Unexpected Empyema Identified by Point-of-Care Ultrasound

CJEM. 2016 Sep;18(5):391-4. doi: 10.1017/cem.2015.71. Epub 2015 Jul 27.

Abstract

There is evidence to suggest that point-of-care ultrasound assessment of the lungs has a higher sensitivity and specificity than chest radiography for the diagnosis of pneumonia. It is unknown if the same is true for pneumonia complications. We present and discuss the case of a 61-year-old woman who presented to the emergency department with confusion, decreased level of consciousness, and signs of sepsis. A chest x-ray revealed a right sided infiltrate. An ultrasound of the patient's lungs was performed, and revealed a complex loculated fluid collection consistent with an empyema. A chest CT confirmed the diagnosis, and immediate percutaneous drainage was performed.

Keywords: PoCUS; emphyema; lung ultrasound.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Critical Illness
  • Diagnosis, Differential
  • Drainage / methods
  • Emergency Service, Hospital
  • Empyema / diagnostic imaging*
  • Empyema / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Pneumonia / diagnostic imaging*
  • Pneumonia / therapy
  • Point-of-Care Systems*
  • Radiography, Thoracic / methods
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Ultrasonography / methods*

Substances

  • Anti-Bacterial Agents