Journal of Emergencies, Trauma, and Shock
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LETTER TO EDITOR  
Year : 2015  |  Volume : 8  |  Issue : 4  |  Page : 244
A case of tension pyothorax with septic shock


Department of Acute Critical Care Medicine, Juntendo University, Chiba, Japan

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Date of Web Publication7-Oct-2015
 

How to cite this article:
Ishikawa K, Hara M, Iwakami Si, Yanagawa Y. A case of tension pyothorax with septic shock. J Emerg Trauma Shock 2015;8:244

How to cite this URL:
Ishikawa K, Hara M, Iwakami Si, Yanagawa Y. A case of tension pyothorax with septic shock. J Emerg Trauma Shock [serial online] 2015 [cited 2020 Jul 15];8:244. Available from: http://www.onlinejets.org/text.asp?2015/8/4/244/161663


Dear Editor,

A 68-year-old male called an ambulance because of left chest pain and dyspnea for 2 days. He had diabetes mellitus, alcoholic hepatitis and interstitial pneumonia treating with a steroid. After checking physical examinations, his blood pressure suddenly decreased 50/36 mmHg. A chest roentgenogram revealed decreased radiolucency of the left thoracic cavity with a right shift of the mediastinum [Figure 1]. An emergency thoracic fluid drainage was executed [Figure 2], and the blood pressure increased up to 94/60 mmHg. The results of a gas analysis of the pleural fluid were compatible with a pyothorax. He was treated in the intensive care unit and discharged alive. This case is the third case report of a pure tension pyothorax. [1],[2] All of these cases were immunocompromised hosts, massive fluid production from infected pleura or pneumonia might have been the cause of the tension state. Urgent appropriate drainage is necessary, or this situation can lead to death.
Figure 1: The first chest roentgenogram the chest roentgenogram revealed decreased radiolucency of the left thoracic cavity with a right shift of the mediastinum

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Figure 2: The second chest roentgenogram the chest roentgenogram showed improvement of the radiolucency of the left lung field and the shift of the mediastinum

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   References Top

1.
Bramley D, Dowd H, Muwanga C. Tension empyema as a reversible cause for cardiac arrest. Emerg Med J 2005;22:919-20.  Back to cited text no. 1
    
2.
Ahern TL, Miller GA. Tension pyothorax causing cardiac arrest. West J Emerg Med 2009;10:61.  Back to cited text no. 2
    

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Correspondence Address:
Youichi Yanagawa
Department of Acute Critical Care Medicine, Juntendo University, Chiba
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2700.161663

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    Figures

  [Figure 1], [Figure 2]



 

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