Incessant Pleural Drainage - Can It Be a Masquerading Esophageal-Pleural Fistula?

JOURNAL TITLE: Indian Journal of Respiratory Care

Author
1. Ajay Kumar Singh
2. Vijay Kumar Mishra
3. Rajesh Kumar Singh
ISSN
2277-9019
DOI
10.4103/ijrc.ijrc_46_18
Volume
8
Issue
1
Publishing Year
2019
Pages
3
  • Article keywords
    Esophageal-pleural fistula, incessant drainage, massive pleural effusion

    Abstract

    Spontaneous esophageal-pleural fistula (EPF) is extremely rare. We present a case of a 52-year gentleman who presented with shortness of breath and decreased appetite, whose chest X-ray and ultrasonogram of thorax depicted a pleural effusion like picture. Intercostal drainage tubes were inserted to alleviate his dyspnea. Plain computerized tomography (CT) thorax initially revealed a pleural cyst, which was surgically drained. Subsequent CT thorax with contrast and barium swallow revealed EPF, which was confirmed with endoscopy. Pleural fluid analysis revealed candida as the cause of EPF. Candida as a cause of EPF that too in an nonimmunocompromised patient is very rare. Multidisciplinary approach is required to diagnose and prevent mortality in such cases.

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