MRCP2-4275
A 58-year-old man presents with fever, chest pain, and difficulty breathing. A chest x-ray reveals a significant pleural effusion on the left side.
Thoracic ultrasound confirms the presence of a large volume pleural effusion and a suitable site is marked for drainage. A chest tube is inserted without any complications and the drainage reveals purulent fluid. The patient’s condition improves post-procedure and vital signs remain stable.
After 24 hours, the pleural effusion shows significant improvement on x-ray and minimal fluid is draining. However, there is bubbling in the underwater seal which has been present since the insertion of the chest tube. Despite this, the patient’s condition continues to improve and the chest tube is still functioning properly.
What is the most likely diagnosis?