Low-dose intrapleural alteplase (without deoxyribonuclease) in complicated parapneumonic effusion

Case series and literature reviews

Carol Lai, Nurashikin Mohammad, Hassan Tidi Maharani, Mohamed Faisal Abdul Hamid

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

This case series reviews two cases of elderly patients who presented with fever, cough and shortness of breath. Clinical examinations and initial chest radiographs confirmed unilateral pleural effusion. Thoracenteses were consistent with exudative pleural effusion. We commenced intravenous antibiotics treating for parapneumonic effusions. The first case showed persistent effusion despite drainage, and the second case had a little aspirate from pleural tapping. Subsequent ultrasound of the thorax showed multiloculated effusions. We made the decisions for intrapleural fibrinolytic therapy using low-dose alteplase 2.5 mg each time, in view of the elderly patient as sacrosanct for risk of bleeding. Furthermore, DNase was not used, as it is not yet available in our setting. Both of our patients had good clinical and radiological outcomes, without the need for surgical interventions.

Original languageEnglish
Article numberbcr-2017-221239
JournalBMJ Case Reports
Volume2017
DOIs
Publication statusPublished - 1 Jan 2017

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Deoxyribonucleases
Tissue Plasminogen Activator
Pleural Effusion
Thorax
Thrombolytic Therapy
Cough
Dyspnea
Drainage
Fever
Hemorrhage
Anti-Bacterial Agents

Keywords

  • drugs and medicines
  • respiratory system

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Low-dose intrapleural alteplase (without deoxyribonuclease) in complicated parapneumonic effusion : Case series and literature reviews. / Lai, Carol; Mohammad, Nurashikin; Tidi Maharani, Hassan; Abdul Hamid, Mohamed Faisal.

In: BMJ Case Reports, Vol. 2017, bcr-2017-221239, 01.01.2017.

Research output: Contribution to journalArticle

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