RT Journal Article SR Electronic T1 Could a handheld point-of-care ultrasound system alter the management of patients with pleural infection? JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e263279 DO 10.1136/bcr-2024-263279 VO 18 IS 3 A1 Wan Ahmed, Wan Aireene A1 Che Rahim, Mohd Jazman A1 Abdul Hamid, Mohamed Faisal YR 2025 UL http://casereports.bmj.com/content/18/3/e263279.abstract 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.