Each daily dose of streptokinase was diluted in 100 mL saline solution and instilled in the pleural cavity via the chest tube, which was then clamped for 4 h. After the 2 treatments, there was a notable increase in the amount of fluid that was draining. The patient improved continuously
thereafter. Her chest tube was removed on day 12 of hospitalization, and she was discharged the following day. The only remarkable finding on a chest x-ray taken the day of discharge was normal (Fig. 3a,b). The patient carried her pregnancy to term. She entered spontaneous labor after 39 weeks’ gestation and gave birth to a healthy female infant by vaginal delivery. A follow-up chest x-ray at 2 months after discharge showed complete
resolution of the pneumonia and empyema. Fig. 1. Chest radiography of patient PF-02341066 manufacturer at presentation. Case 2. A 39-year-old woman in her 29th week of pregnancy presented to hospital with a 15-day history of dyspnea, chest pain, fever, and productive cough. Her chest x-ray showed a pleural effusion in the right chest. The fetus’ condition was assessed by ultrasound Veliparib research buy and found to be normal. Thoracocentesis revealed pus. A chest tube was inserted and 700 mL of purulent fluid were drained. Despite placement of the tube and use of suction, the amount of drainage was considered inadequate. Chest radiography showed an organized fluid collection in the right hemithorax and consolidation and partial collapse of the lower lobe of the right lung (Fig. 4a,b). Thoracic magnetic resonance imaging demonstrated elevation of the diaphragm, loculated pleural fluid, and atelectasis of the lower right lung lobe (Fig. 5a,b). Fibrinolytic therapy was initiated, with 250,000 units streptokinase diluted in 100 ml saline and instilled DNA ligase into the pleural cavity via the chest tube. The tube was then clamped for 4 h. This treatment was repeated daily for
the next 3 days. A chest x-ray after the fourth day of enzymatic debridement showed complete resolution of the pleural collection and re-expansion of the lower right lung lobe (Fig. 6). By day 10 of hospitalization, the drainage had reduced to less than 100 ml daily and the chest tube was removed. After the patient was discharged, her pregnancy continued uneventfully. At 40 weeks’ gestation, she had a healthy child via uncomplicated vaginal delivery. Fig. 4. a. Chest radiography of patient at presentation; b. Chest radiography of patient after tube thoracostomy. Pneumonia during pregnancy is uncommon but poses potentially serious risks to both mother and fetus. It is estimated that at least 40% of patients who are hospitalized with pneumonia develop a parapneumonic effusion.1 There is considerable variation in the clinical course of this condition. Pneumonia is complicated by empyema in approximately 8% of all cases of pneumonia in pregnancy.