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Fungal empyema thoracis complicating treatment of oesophageal carcinoma.(Images in Medicine)(Brief Article)

Postgraduate Medical Journal

| March 01, 2004 | Hull, J.H.K.; Kendall, A.; Lofts, F. | COPYRIGHT 2004 British Medical Association. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

A 56 year old man with locally advanced oesophageal carcinoma was admitted with neutropenic (0.6 X [10.sup.9]/1) sepsis 10 days after chemotherapy with etoposide, cisplatin, and capecitabine. At presentation there was evidence of marked respiratory compromise and subsequent chest radiography demonstrated a large right sided pleural effusion. Diagnostic thoracocentesis revealed frank malodorous pus from which Candida albicans was repeatedly isolated. A large bore (32F) chest tube was inserted and he was started on intravenous broad spectrum antibiotics and fluconazole.

At initial diagnostic biopsy of malignancy a mediastinal perforation occurred which necessitated placement of a covered oesophageal stent. Consequently, there was a high clinical suspicion of abnormal ...

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