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Page 4 / Case 01/01


The Respirology team was consulted. A chest ultrasound was done urgently, and the fluid was drained with a chest tube. The chest ultrasound (presented below) showed a left pleural effusion with incomplete septa without debris in it. It also confirmed consolidation of the left lower lobe.

ENLARGE this ULTRASOUND

The patient went to the PICU on 1 LPM of O2 with a sat of 95%. He was switched from cefuroxime to ceftriaxone.

His labs before going to the PICU were as follows :

Capillary Blood Gas: pH 7.48, pCO2 34

WBC 26, neutrophils 20, bands 0.5

Hb 108, platelets, 62 PT/PTT normal with increased fibrinogen and increased D-dimers (>0.5 <1.0)

Pleural fluid:
– RBC 3840
– WBC 17280, neutrophils 91%, monocytes 9%
– LDH 71328, protein 44.6, glucose < 1.1
– dark brown, containing filaments
– gram stain showed no acid fast bacilli

WOULD ANYONE HAVE DONE ANYTHING DIFFERENTLY AT THIS POINT?



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