Case A 45-year-old male presented with shortness of breath and left-sided pleuritic chest pain. Lost 20-pound weight in the last one year Vital signs were normal He denied any joint pain or joint swelling.
Rheumatoid nodules were absent Chest examination revealed dullness over the left chest with decreased breath sound Medical History : 2 weeks ago the patient had undergone left sided thoracentesis Diagnostics Hematocrit was 30%: WBC was 7900mm3 A chest x-ray showed presence of large left sided pleural effusion Thoracentesis was performed with chest tube placement Pleural fluid was bloody and the analysis was: Pleural cell count 4000 mm3 (45% neutrophils, 40% lymphocytes, 15% eosinophils) Lactate dehydrogenase (LDH) : 1253 U/l Total protein 5.5 g/dl; Glucose 15mg/dl Cytologic examination showed acute inflammatory cells but no evidence of malignancy Pleural biopsy and pleurodesis…
