Journal Article

Hepatic hydrothorax: indwelling catheter-related Acinetobacter radioresistens infection

Nascimento, Paula Oliveira, Barata Moura, Rita, Silva Cruz, Cristiano, Tosatto, Valentina

2019

Overview

Hepatic hydrothorax, a rare and debilitating complication of cirrhosis, carries high morbidity and mortality. First-line treatment consists of dietary sodium restriction and diuretic therapy. Some patients, mainly those who are refractory to medical management, will require invasive pleural drainage. The authors report the case of a 76-year-old man in a late cirrhotic stage of alcoholic chronic liver disease, presenting with recurrent right-sided hepatic hydrothorax, portal hypertension, hepatosplenomegaly and thrombocytopaenia. After recurrent admissions and complications, the potential for adjusting diuretic therapy was limited. After unsuccessful talc pleurodesis, an indwelling tunnelled pleural catheter was placed with effective symptomatic control. One month later, the patient was readmitted with empyema due to Acinetobacter radioresistens. Despite optimised medical and surgical treatment, the patient died 4 weeks later.

• Publisher: BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Acinetobacter / Acinetobacter Infections - etiology / Aged / Bacterial infections / Case reports / Catheters / Catheters, Indwelling - adverse effects / Diuretics / Electrolytes / Emergency medical care / Hospitals / Humans / Hydrothorax - diagnostic imaging / Hydrothorax - etiology / Hydrothorax - therapy / Hypertension / Liver cirrhosis / Liver Cirrhosis, Alcoholic - complications / Liver diseases / Male / Mortality / Nosocomial infections / Patients / Radiography / Systematic review / Unusual Presentation of More Common Disease/Injury