PMC7270608_01
Chest radiograph (A) before intra-pleural alteplase and DNase showing right sided effusion (B) post 3 doses intra-pleural alteplase and DNase with resolution of right sided effusion. CT Thorax (C) before intrapleural fibrinolysis and (D) 2 weeks post Intrapleural fibrinolytics showing successful resolution of right sided empyema.
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Scans (Fig. 1C and D) showed significant improvement. She was discharged well.
PMC7270608_02
A schematic diagram showing serial chest radiographs; (A) Before treatment with a moderate right sided pleural effusion, (B) Day 1 post, (C) Day 3 post, (D) Day 5 post intra-pleural alteplase and DNase. This diagram demonstrates the significant improvement of the complex right pleural effusion.
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Post-operatively, she developed nosocomial pneumonia which developed into a right parapneumonic effusion requiring non-invasive ventilation (Fig. 2A). A total of 2.1L of haemoserous fluid was drained and serial chest X-rays (Fig. 2B and C) showed significant improvement.