60 f,progressive dyspnea and cough fever since 5days.diagnosed rt sided pleural effusion with turbid yellow fluid.ICD placed posteriorly infrascapular region from loculated collection.350 ml fluid drained out. plz comment on ct thorax and pleural fluid examination and further management.

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Acute history of Fever, Cough n Dyspnea... Loculated Pleural Effusion TLC in the range of 1540 with Neutrophilic Leukocytosis.... Definitely Empyema is a differential... There are three stages: exudative, when there is an increase in pleural fluid with or without the presence of pus; fibrinopurulent, when fibrous septa form localized pus pockets; and the final organizing stage, when there is scarring of the pleura membranes with possible inability of the lung to expand Start broad spectrum Antibiotics and i would like to know the pH of Pleural fluid... Anyhow rule out PTB and SynPneumonic effusion

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Empyrean Thoracis .Pleural fluid for culture sensitivity . And also for AFB and Malignant cells . Sputum for culture sensitivity &AFB ,Malignant cells . Pending results Broad spectrum antibiotics 7 days Intercostal drainage till drained fluid is less than 30 ml .

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acute history with neutrophilic fluid s/o synpneumonic effusion; treat with antibiotics for 7-10 days; aspirate as much as possible

Emphyema, drainage must, septation noted start piperacillin and vancomycin, after that antiTB, check for afb, genexpert

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Pleural effusion right.

PLEURAL FLUID IS TRANSUDATE TOTAL COUNT IS HIGH POLYMORPH IS HIGH ------> C & S SPTUM FOR C & S . RX A NTIBIOTIC + PROBIOTIC

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culture senstivity and sputum culture send for afb and biopsy should be done to rule out suspecious malignacy ..and start broad spectrum antibiotics with cardiopulmonary support for dyspnea ...

If it would have been empyema be or t.b fluid should be exudative.probable diagnosis malignancy.

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Pleural fluid look to b exudative.u cn make it out by lights criteria S.protein n s.LDH ratio with PMN+++ with high esr n high neutrophils.though i m not a radiologist ct thorax look to b ?paraneumonic effusion.D/D is 1.parapneumonic effusion2.PTB 3.malignancy. 2decho p.fluid for cytology culture n malignant cells.thnx sir nice case to b discussed

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