Empyema and Respiratory Failure Secondary to Nephropleural Fistula Caused by Chronic Urinary Tract Infection: A Case Report
We report a case of nephropleural fistula causing empyema and respiratory failure in a 68-year-old gentleman with a long history of urological problems including recurrent nephrolithiasis and urinary tract infections. He was admitted with sepsis, a productive cough, pyuria, and reduced breath sounds...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Case Reports in Pulmonology |
| Online Access: | http://dx.doi.org/10.1155/2012/595402 |
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| author | G. H. Jones H. R. Kalaher N. Misra J. Curtis R. J. Parker |
| author_facet | G. H. Jones H. R. Kalaher N. Misra J. Curtis R. J. Parker |
| author_sort | G. H. Jones |
| collection | DOAJ |
| description | We report a case of nephropleural fistula causing empyema and respiratory failure in a 68-year-old gentleman with a long history of urological problems including recurrent nephrolithiasis and urinary tract infections. He was admitted with sepsis, a productive cough, pyuria, and reduced breath sounds over the left hemithorax. Radiological imaging revealed a fistulous connection between a left-sided perinephric abscess and the pleural space. He was commenced on broad spectrum intravenous antibiotics but developed progressive respiratory failure requiring intensive care admission. Urinary and pleural aspirates cultured facultative anaerobic pathogens with identical resistance patterns. Drainage of thoracic and perinephric collections was carried out, allowing him to be extubated after 24 hours and discharged home after 18 days on an extended course of oral antibiotics. Left nephrectomy is now planned after a period of convalescence. Empyema developing in patients with known urolithiasis should alert the treating physician to the possibility that a pathological communication has formed especially if typical urinary tract pathogens are cultured from respiratory sampling. |
| format | Article |
| id | doaj-art-c8588fdc99ce486b9e9fce5814a08099 |
| institution | DOAJ |
| issn | 2090-6846 2090-6854 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pulmonology |
| spelling | doaj-art-c8588fdc99ce486b9e9fce5814a080992025-08-20T03:24:03ZengWileyCase Reports in Pulmonology2090-68462090-68542012-01-01201210.1155/2012/595402595402Empyema and Respiratory Failure Secondary to Nephropleural Fistula Caused by Chronic Urinary Tract Infection: A Case ReportG. H. Jones0H. R. Kalaher1N. Misra2J. Curtis3R. J. Parker4School of Medicine, Mersey Deanery, Regatta Place, Brunswick Business Park, Summers Road, Liverpool L3 4BL, UKSchool of Medicine, Mersey Deanery, Regatta Place, Brunswick Business Park, Summers Road, Liverpool L3 4BL, UKDepartment of Surgery, Aintree University Hospitals, NHS Foundation Trust, Lower Lane, Liverpool L9 7AL, UKDepartment of Radiology, Aintree University Hospitals, NHS Foundation Trust, Lower Lane, Liverpool L9 7AL, UKDepartment of Respiratory Medicine, Aintree University Hospitals, NHS Foundation Trust, Lower Lane, Liverpool L9 7AL, UKWe report a case of nephropleural fistula causing empyema and respiratory failure in a 68-year-old gentleman with a long history of urological problems including recurrent nephrolithiasis and urinary tract infections. He was admitted with sepsis, a productive cough, pyuria, and reduced breath sounds over the left hemithorax. Radiological imaging revealed a fistulous connection between a left-sided perinephric abscess and the pleural space. He was commenced on broad spectrum intravenous antibiotics but developed progressive respiratory failure requiring intensive care admission. Urinary and pleural aspirates cultured facultative anaerobic pathogens with identical resistance patterns. Drainage of thoracic and perinephric collections was carried out, allowing him to be extubated after 24 hours and discharged home after 18 days on an extended course of oral antibiotics. Left nephrectomy is now planned after a period of convalescence. Empyema developing in patients with known urolithiasis should alert the treating physician to the possibility that a pathological communication has formed especially if typical urinary tract pathogens are cultured from respiratory sampling.http://dx.doi.org/10.1155/2012/595402 |
| spellingShingle | G. H. Jones H. R. Kalaher N. Misra J. Curtis R. J. Parker Empyema and Respiratory Failure Secondary to Nephropleural Fistula Caused by Chronic Urinary Tract Infection: A Case Report Case Reports in Pulmonology |
| title | Empyema and Respiratory Failure Secondary to Nephropleural Fistula Caused by Chronic Urinary Tract Infection: A Case Report |
| title_full | Empyema and Respiratory Failure Secondary to Nephropleural Fistula Caused by Chronic Urinary Tract Infection: A Case Report |
| title_fullStr | Empyema and Respiratory Failure Secondary to Nephropleural Fistula Caused by Chronic Urinary Tract Infection: A Case Report |
| title_full_unstemmed | Empyema and Respiratory Failure Secondary to Nephropleural Fistula Caused by Chronic Urinary Tract Infection: A Case Report |
| title_short | Empyema and Respiratory Failure Secondary to Nephropleural Fistula Caused by Chronic Urinary Tract Infection: A Case Report |
| title_sort | empyema and respiratory failure secondary to nephropleural fistula caused by chronic urinary tract infection a case report |
| url | http://dx.doi.org/10.1155/2012/595402 |
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