PMC8349083_01
(a)Caption: Representative sections of a CT scan (axial section on the left (a), coronal section on the right (b)) showing bilateral pleural effusions with loculations at the lung bases.
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A CT of the abdomen demonstrated bilateral loculated pleural effusions at the lung bases (Fig. 1).
(bCaption: Yellow-green empyema fluid (a) after placement of bilateral 14 french pigtail catheters (b). (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
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A diagnostic thoracentesis showed frank yellow-green pus (Fig. 2a) with 29,550 nucleated cells (34% segs) per microliter, LDH of 7161 U/L, glucose of <5 mg/dL, pH of 7 and triglycerides of 66 mg/dL. Bilateral 14 French chest tubes were placed (Fig. 2b) and fibrinolytics (5mg t-PA/5mg DNase) were instilled into each tube 8-12 hours apart.
Caption: CT scan sections showing near-complete resolution of bilateral empyema after discharge with coronal (a)(b) and axial (c) views.
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She was discharged on 4 weeks of ceftriaxone and a repeat chest CT showed near complete resolution of empyema (Fig. 3).