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

Open Journal of Radiology 2023年第3期13卷 134-138页

作者： 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

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

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