Goel Manoj K, Juneja Deven, Jain Satinder K, Chaudhuri Saikiran, Kumar Ajay
Department of Pulmonology, Critical Care and Sleep Medicine, Delhi Heart and Lung Institute 3 MM - II Panchkuian Road, New Delhi - 110 055, India.
Lung India. 2010 Jan;27(1):27-9. doi: 10.4103/0970-2113.59265.
A 57-year-old diabetic and hypertensive man presented with a short history of fever, dry cough and right side chest pain. A chest radiograph showed right pleural based homogenous shadow in middle and lower zones with obliteration of right costo-phrenic angle suggestive of right side effusion. Aspiration of pleural fluid revealed frank pus for which inter-costal tube drainage was performed. Due to persistence of empyema, the patient was subjected to thoracoscopy. Thoracoscopy showed multiloculated empyema. Thoracoscopic pleural biopsy and fluid showed septate fungal hyphae. Thoracotomy and parietal pleurectomy, with resection of part of right lower lobe, was carried out. Pleural fluid, pleural and lung tissue culture grew Aspergillus fumigatus. The patient showed good recovery with voriconazole after thoracotomy.
一名57岁的糖尿病和高血压男性患者，出现发热、干咳和右侧胸痛的病史较短。胸部X线片显示右中下肺野有均匀阴影，右肋膈角消失，提示右侧胸腔积液。胸腔穿刺抽出脓性液体，遂行肋间置管引流。由于脓胸持续存在，患者接受了胸腔镜检查。胸腔镜检查显示为多房性脓胸。胸腔镜胸膜活检及胸水检查发现有分隔的真菌菌丝。遂行开胸手术及壁层胸膜切除术，并切除右下叶部分肺组织。胸水、胸膜及肺组织培养均生长出烟曲霉。开胸手术后患者使用伏立康唑治疗，恢复良好。
