Empyema complicated with nephropleural fistula and perinephric abscess

Department

Internal Medicine

Additional Department

Pulmonary Medicine

Document Type

Article

Publication Title

BMJ Case Reports

Abstract

The coexistence of empyema, nephropleural fistula and perinephric abscess is rare and presents diagnostic challenges, especially when patients exhibit atypical or mild symptoms. This case report details a female in her early 90s who presented with 3 weeks of chest pain and was found to have a left-sided pleural effusion. Further imaging revealed additional findings of a left-sided nephropleural fistula and left perinephric collection. The patient underwent thoracentesis and video-assisted thoracoscopic surgery, with cultures growing Streptococcus Anginosus Subsequently, she underwent a left nephrectomy, with pathology findings consistent with chronic pyelonephritis and a fistulous tract. The patient was discharged on intravenous antibiotics. Follow-up imaging showed improvement. The patient completed the antibiotic course and reported symptom resolution 2 weeks after discharge.

First Page

e259015

DOI

10.1136/bcr-2023-259015

Volume

17

Issue

10

Publication Date

10-17-2024

Medical Subject Headings

Humans; Female; Nephrectomy; Abscess; Aged, 80 and over; Anti-Bacterial Agents; Streptococcal Infections; Pleural Effusion; Empyema, Pleural; Pyelonephritis; Streptococcus anginosus; Thoracic Surgery, Video-Assisted; Urinary Fistula; Thoracentesis; Fistula; Kidney Diseases

PubMed ID

39419598

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