This is an update of the case of 22yr/M BPO worker with high grade fever. Total 2200 ml of Haemorrhagic pleural fluid was aspirated in two sessions and immediately after the following CXR has been taken. Patient is stil having high Fever, Pleural fluid CBNAAT is negative.

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rule out malignancy; as hemorrhagic effusion with same side shift in cxr; if possible go for thoracoscopy after ruling out endobronchial obstruction in bronchoscopy

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Same side shift after that much of aspiration of pleural fluid and still present points to some hemorrhage or malignancy if there is no H/O trauma.

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Get broncoscopy done Hemorrhagic effusion r/o malignancy

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Pleural effusion right with fibrocavitary lesions right lung.

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Sir even than i suspacted malignancy and now also the lesion is seen in rt middle lobe with hemorrhagic hydropneumothorax

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Haemorrhagic pleural fluid is either traumatic or malignant.pleural fluid protein and cell morphology. and CT chest should be ordered.

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As effusion is exudate haemorrhagic exclude Malignancy

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Rule out malignancy...thoracoscopic biopsy is what we need for confirmation.

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I suspacted malignancy even than it looks to be ca lung on present x-ray chest thelesion can be seen in rt middle lobe with hemorrhagic hydrothorax

Rt uz, mz infiltration , pleural effusion; Ct chest,pleural fluid culture, Viral serology Antibiotics till reports come.

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