Canadian Medical Association Journal: Practice

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CASES

Re-expansion pulmonary edema following thoracentesis
July 19, 2010

Shortness of breath developed in a 24-year-old man soon after drainage of an empyema. Although uncommon after drainage of a pneumothorax or pleural effusion, re-expansion pulmonary edema occurs usually within 24 hours after the procedure, says Kasmani and colleagues. Treatment is supportive. Preventive measures include using low negative pressure for suction and limiting the volume of fluid drained. Full article

WHAT IS YOUR CALL?

Bilateral pleural effusions
July 12, 2010

Bilateral pleural effusions developed in a 50-year-old woman with large B-cell lymphoma. Aspiration at thoracentesis showed milky off-white to yellow fluid. What is your diagnosis? Full article

IMAGE: Massive “sweet” hydrothorax

PRIMER

Legionellosis: Why should I test and report?
July 5, 2010

Although sporadic cases of legionellosis are often treated without empiric testing to confirm the diagnosis, individual cases should be fully investigated because they may be the harbinger of a larger outbreak. Marrie and colleagues stress that detection of Legionella antigen in urine takes about an hour. Mapping of the timing and locations of cases may allow identification of the source of exposure and initiation of remediation measures. Full article