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Home | Ultrasound Library | Empyema Case 1

Empyema Case 1

by Dr James Rippey, last update September 13, 2019

A poorly kempt, chronic alcoholic with a history of intravenous drug use presents to ED. He is confused, febrile, tachycardic, tachypenoeic and hypoxic.

What does this ultrasound clip of his chest show?

Longitudinal view
Transverse View
Transverse view

Reveal answer
  • There is a large pleural effusion.
  • The lung is collapsed with a few small echogenic aerated patches remaining.
  • Numerous fibrinous strands are attached to the visceral pleural surface and are waving in the fluid as the transmitted cardiac pulsations move the lung.
  • The features are consistent with a fibrino-purulent empyema, which was confirmed on aspiration of the fluid.

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About Dr James Rippey

Emergency physician with a passion for ultrasound and educating the masses. Author of the Ultrasound library and Ultrasound Top 100. @theSonoCave | + James Rippey

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