Brown Michelle, Heffernan Carly, Wray Alisa
University of California, Irvine, Department of Emergency Medicine, Orange, CA.
J Educ Teach Emerg Med. 2021 Oct 15;6(4):V19-V23. doi: 10.21980/J8SH2N. eCollection 2021 Oct.
An empyema is a pus-filled collection within the pleural space of the thorax that most commonly results from an untreated pneumonia. Additional risk factors include poor dental hygiene, malnutrition, immunosuppression, alcohol or IV drug use, and gastroesophageal reflux. Symptoms typically include a productive cough, fever, and pleuritic chest pain, and radiographic imaging is necessary for diagnosis.1 In this case report, an adult male presented to the emergency department (ED) with a productive cough and shortness of breath. Ultrasound and computed tomography (CT) imaging confirmed the diagnosis of a left-sided empyema. The patient was successfully treated with a chest tube and antibiotics and was subsequently discharged eight days after admission. This case demonstrates the effectiveness of ultrasound and CT in diagnosing an empyema from other lung conditions. Ultrasound has the potential to visualize additional features not always seen on CT alone, which suggests the possibility of lung ultrasound as an alternative to a chest CT when diagnosing patients in at-risk radiation exposure groups, including children and pregnant women.
Empyema, lung ultrasound, chest tube.
脓胸是胸腔胸膜腔内充满脓液的积聚，最常见于未经治疗的肺炎。其他危险因素包括口腔卫生差、营养不良、免疫抑制、酗酒或静脉吸毒以及胃食管反流。症状通常包括咳痰、发热和胸膜炎性胸痛，诊断需要进行影像学检查。在本病例报告中，一名成年男性因咳痰和呼吸急促就诊于急诊科。超声和计算机断层扫描（CT）成像确诊为左侧脓胸。患者通过胸腔闭式引流管和抗生素治疗成功康复，入院八天后出院。本病例展示了超声和CT在诊断脓胸与其他肺部疾病方面的有效性。超声有可能显示出单独CT检查时不常看到的其他特征，这表明在诊断包括儿童和孕妇在内的有辐射暴露风险的患者时，肺部超声有可能替代胸部CT。
脓胸、肺部超声、胸腔闭式引流管
