Work

Complex Interplay of Empyema and Chylothorax: A Case Report With Nutritional and Clinical Implication

Year: 2026

Type: article

Abstract: Empyema and chylothorax are distinct but serious pleural space complications, with the simultaneous occurrence being exceedingly rare and clinically challenging. We present the case of a 78-year-old immunocompromised male with small-cell lung cancer who developed concurrent empyema and chylothorax. The patient presented with respiratory distress and signs of sepsis, and imaging revealed pleural effusion with lung collapse. Thoracostomy yielded a large volume of milky, purulent chylous fluid positive for Streptococcus sp., confirming infected chylothorax (empyema). Management included broad-spectrum tailored antibiotics, chest tube drainage, octreotide administration, and a parenteral nutrition regimen to address nutritional losses from chyle leakage. Despite initial clinical improvement, the patient succumbed to ventilator-associated pneumonia after 20 days of hospitalization. This rare case underscores the critical importance of early diagnosis and a multidisciplinary approach, including tailored nutritional therapy, for optimizing outcomes in patients with combined empyema and chylothorax.

Source: Cureus

DOI: 10.7759/cureus.101403

Authors: Sofia Pouriki, Dimitrios Karagiannis, Theoni Agapitou, Asimina Rautopoulou, Zafiria Mastora

Institutions: Sotiria General Hospital, Evangelismos Hospital

Language: English

Topic: Lymphatic Disorders and Treatments

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7123358042