Affiliations 

  • 1 Department of Radiology, Universiti Sains Malaysia Health Campus, Kubang Kerian, Kelantan, Malaysia
  • 2 Hospital Pakar Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia drjazman@usm.my
  • 3 Faculty of Medicine Universiti Kebangsaan Malaysia, Cheras, Federal Territory of Kuala Lumpur, Malaysia
BMJ Case Rep, 2025 Mar 14;18(3).
PMID: 40086834 DOI: 10.1136/bcr-2024-263279

Abstract

Lung ultrasonography is an essential tool in the management of pleural infection. We report the usage of lung point-of-care ultrasound (POCUS) using a handheld ultrasound system (HHUS), which changed the immediate management of a complex pleural effusion.A middle-aged diabetic patient presented with fever, dyspnoea and left-sided pleuritic chest pain, suggestive of left pleural infection. Lung POCUS using a HHUS showed a multiloculated pleural effusion with no connections between the locules, and this was confirmed later with CT, along with left empyema necessitans. An upfront video-assisted thoracoscopy was done instead of catheter drainage and intrapleural enzyme therapy. Methicillin-sensitive Staphylococcus aureus was grown from the drained pus. The patient was subsequently discharged with prolonged antibiotic treatment.Lung POCUS by a trained physician is useful in deciding the immediate management of pleural infection. Modern HHUS provides a practical and reliable method for identifying and characterising pleural effusion.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.