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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 77-year-old man with a history of chronic obstructive pulmonary disease&#44; pneumoconiosis and pulmonary tuberculosis as a youth&#44; which were treated with left collapse therapy&#44; leaving behind a destroyed lung and residual productive pleurisy&#46; The patient consulted for dyspnea&#44; bronchorrhea and fever&#46; The chest radiography revealed a left pleural effusion with an air-fluid level &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#44; arrow&#41; and a right pneumonic condensation&#46; The chest computed tomography showed a bronchopleural fistula &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#44; arrow&#41; with opacification of the postuberculous residual cavity &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#44; asterisk&#41;&#46; The pleural fluid was purulent&#44; with negative results for the microbiological studies for <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> and other germs&#46; Despite antibiotic treatment with amoxicillin-clavulanate for 4 weeks and with piperacillin-tazobactam for 3 more weeks&#44; the fever&#44; bronchorrhea and general deterioration persisted&#46; Radiologically&#44; the only change was the disappearance of the right condensation&#46; A permanent open thoracostomy was therefore performed &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#41; to evacuate&#44; with progressive closure as a second intent&#46; In <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>D&#44; we can see the exposed lung with air bubbles&#44; which shows the persistence of the bronchopleural fistula&#46; No intrapleural therapy or vacuum-assisted closure was performed&#46; The patient experienced a postoperative complication and died a month later&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>"
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January - February 2018 Open thoracostomy as treatment of chronic empyema with bronchopleural fistula
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Vol. 218. Issue 1.
Pages 38-39 (January - February 2018)
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Vol. 218. Issue 1.
Pages 38-39 (January - February 2018)
Medicine in images
DOI: 10.1016/j.rceng.2017.10.002
Open thoracostomy as treatment of chronic empyema with bronchopleural fistula
Toracostomía abierta como tratamiento de un empiema crónico con fístula broncopleural
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M.N. Solís-Marquínez
Corresponding author
natayasolis@gmail.com

Corresponding author.
, J.F. López-Caleya
Servicio de Medicina Interna, Hospital Universitario de Cabueñes, Gijón (Asturias), Spain
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