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  • Investigating a unilateral pleural effusion: A tale of a medical error and diagnostic delays

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    Author(s)
    Welagedara, Suminda
    Swe, Tokyo Moe
    Sriram, Krishna Bajee
    Griffith University Author(s)
    Sriram, Krishna K.
    Welagedara, Suminda
    Year published
    2017
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    Abstract
    We report the case of an elderly Asian man where a medical error and diagnostic delays obscured the diagnosis of pleural tuberculosis (TB). The patient was hospitalized for evaluation of a unilateral pleural effusion. Initially, the patient was subjected to a pleural aspiration on the wrong side due to a lack of bedside ultrasound guidance. Subsequently, the patient underwent several investigations but not a blind closed pleural biopsy (BCPB) due to a lack of equipment. Furthermore, the patient was deemed to be too sick to undergo a thoracoscopic pleural procedure. Eventually, a bronchoscopy was performed, and washings from ...
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    We report the case of an elderly Asian man where a medical error and diagnostic delays obscured the diagnosis of pleural tuberculosis (TB). The patient was hospitalized for evaluation of a unilateral pleural effusion. Initially, the patient was subjected to a pleural aspiration on the wrong side due to a lack of bedside ultrasound guidance. Subsequently, the patient underwent several investigations but not a blind closed pleural biopsy (BCPB) due to a lack of equipment. Furthermore, the patient was deemed to be too sick to undergo a thoracoscopic pleural procedure. Eventually, a bronchoscopy was performed, and washings from the right upper lobe were cultured, which established the diagnosis of TB. This case highlights the need to use bedside ultrasound in the investigation of pleural effusions, the role of BCPB especially in frail patients and finally the utility of bronchoscopy in establishing a diagnosis of pleural TB.
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    Journal Title
    Lung India
    Volume
    34
    Issue
    1
    DOI
    https://doi.org/10.4103/0970-2113.197108
    Copyright Statement
    © The Author(s) 2017. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0) License (http://creativecommons.org/licenses/by-nc-sa/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited. If you alter, transform, or build upon this work, you may distribute the resulting work only under a licence identical to this one.
    Subject
    Cardiovascular medicine and haematology
    Cardiovascular medicine and haematology not elsewhere classified
    Immunology
    Publication URI
    http://hdl.handle.net/10072/377071
    Collection
    • Journal articles

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