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M/ 25 with massive pleural effusion

Submitted by Dr TANG Kam Shing on 19 March 2009
ICU, Tuen Mun Hospital

This 25-year old man living in hostel had severe mental retardation.  He was admitted for fever for a few days and dyspnoea.  He required intubation soon after hospital attendance and was admitted to the ICU. The CXR showed massive left pleural effusion.  Chest tapping was tried a few times but failed.  USG of the left chest was done and the image is shown below.  What is the pathology?

 

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Answer: the USG showed a organized pleural effusion with almost no fluid components already.  pleural tapping or drainage is abandoned and thoracic surgeons were consulted for decortication