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Empyema Case 1

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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An Emergency physician based in Perth, Western Australia. Professionally my passion lies in integrating advanced diagnostic and procedural ultrasound into clinical assessment and management of the undifferentiated patient. Sharing hard fought knowledge with innovative educational techniques to ensure knowledge translation and dissemination is my goal. Family, wild coastlines, native forests, and tinkering in the shed fills the rest of my contented time. | SonoCPDUltrasound library | Top 100 | @thesonocave |

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