Ultrasound Value in the Management of Parapneumonic Pleural Effusions in a Limited-Resource Setting: A Case Report  

作　　者：Joseph-Francis Nwatsock Ambroise-Merci Seme Engoumou Maggy Mbede Christopher Vagoda Sinbaï Christopher Vagoda Sinbaï Amos Ela Bela Emilienne Guegang Goujou Joseph-Francis Nwatsock;Ambroise-Merci Seme Engoumou;Maggy Mbede;Christopher Vagoda Sinbaï;Christopher Vagoda Sinbaï;Amos Ela Bela;Emilienne Guegang Goujou(Department of Medical Imaging and Radiotherapy, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon;Department of Radiology, Yaoundé General Hospital, Yaoundé, Cameroon;Department of Thoracic and Vascular Surgery, Yaoundé General Hospital, Yaoundé, Cameroon)

机构地区：[1]Department of Medical Imaging and Radiotherapy, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon [2]Department of Radiology, Yaoundé General Hospital, Yaoundé, Cameroon [3]Department of Thoracic and Vascular Surgery, Yaoundé General Hospital, Yaoundé, Cameroon

出　　处：《Open Journal of Radiology》2023年第3期134-138,共5页放射学期刊（英文）

摘　　要：Pleural effusion is a common complication of acute lung infection, with rising morbidity and mortality. If poorly treated, parapneumonic effusion evolves to the fibrino-purulent stage wherein antibiotic therapy alone becomes inadequate. Chest CT is the gold standard diagnostic imaging tool, however, in a resource-limited context, it may not be performed. Chest ultrasound can therefore be an alternative for drainage and intermittent follow-up of complicated parapneumonic pleural effusions. We report the case of a 4-year-old child who presented with cough, breathing difficulties and fever for over two weeks and in whom an initial chest X-ray revealed a left hemithorax white-out with an air-fluid level. Chest ultrasound revealed a left pleuropulmonary massive fluid collection with an encysted empyema. It also allowed ultrasound-guided pleural effusion drainage of a fibrino-purulent liquid which tested positive for Kocuria kristinae, a bacterium sensitive to gentamycin, vancomycin, norfloxacin and clindamycin. The next follow-up ultrasound checks showed improvement and the control chest X-ray performed one month later demonstrated pulmonary functional recovery. This case highlights the importance of ultrasound in the management and follow-up of this chest pathology in resource-limited settings.Pleural effusion is a common complication of acute lung infection, with rising morbidity and mortality. If poorly treated, parapneumonic effusion evolves to the fibrino-purulent stage wherein antibiotic therapy alone becomes inadequate. Chest CT is the gold standard diagnostic imaging tool, however, in a resource-limited context, it may not be performed. Chest ultrasound can therefore be an alternative for drainage and intermittent follow-up of complicated parapneumonic pleural effusions. We report the case of a 4-year-old child who presented with cough, breathing difficulties and fever for over two weeks and in whom an initial chest X-ray revealed a left hemithorax white-out with an air-fluid level. Chest ultrasound revealed a left pleuropulmonary massive fluid collection with an encysted empyema. It also allowed ultrasound-guided pleural effusion drainage of a fibrino-purulent liquid which tested positive for Kocuria kristinae, a bacterium sensitive to gentamycin, vancomycin, norfloxacin and clindamycin. The next follow-up ultrasound checks showed improvement and the control chest X-ray performed one month later demonstrated pulmonary functional recovery. This case highlights the importance of ultrasound in the management and follow-up of this chest pathology in resource-limited settings.

关 键 词：Chest Ultrasound Ultrasound-Guided Pleural Puncture Parapneumonic Effusion 

分 类 号：R73[医药卫生—肿瘤]