PT  - JOURNAL ARTICLE
AU  - Wan Ahmed, Wan Aireene
AU  - Che Rahim, Mohd Jazman
AU  - Abdul Hamid, Mohamed Faisal
TI  - Could a handheld point-of-care ultrasound system alter the management of patients with pleural infection?
AID  - 10.1136/bcr-2024-263279
DP  - 2025 Mar 01
TA  - BMJ Case Reports
PG  - e263279
VI  - 18
IP  - 3
4099  - http://casereports.bmj.com/content/18/3/e263279.short
4100  - http://casereports.bmj.com/content/18/3/e263279.full
SO  - BMJ Case Reports2025 Mar 01; 18
AB  - Lung ultrasonography is an essential tool in the management of pleural infection. We report the usage of lung point-of-care ultrasound (POCUS) using a handheld ultrasound system (HHUS), which changed the immediate management of a complex pleural effusion.A middle-aged diabetic patient presented with fever, dyspnoea and left-sided pleuritic chest pain, suggestive of left pleural infection. Lung POCUS using a HHUS showed a multiloculated pleural effusion with no connections between the locules, and this was confirmed later with CT, along with left empyema necessitans. An upfront video-assisted thoracoscopy was done instead of catheter drainage and intrapleural enzyme therapy. Methicillin-sensitive Staphylococcus aureus was grown from the drained pus. The patient was subsequently discharged with prolonged antibiotic treatment.Lung POCUS by a trained physician is useful in deciding the immediate management of pleural infection. Modern HHUS provides a practical and reliable method for identifying and characterising pleural effusion.