At the same time, empirical antibiotic therapy (ceftriaxone and clindamycin) was started. 2A) after drainage, showed improvement of the pleural effusion. Blood gas revealed type 1 respiratory failure (paO2/FiO2 223) and analyses identified leukocytosis with neutrophilia and increased inflammatory parameters (C-reactive protein 39 mg/dL, normal 3100 IU/L, pH 6.0. Physical examination revealed cachexia (BMI of 14.8 kg/m2), tachycardia, tachypnea, and decreased breath sounds in the lower half of the right lung field. The authors report a case of a 49-year-old male, smoker of 20 packs per year, who went to the emergency department with fever, dyspnea, cough, purulent sputum, and right posterior pleuritic chest pain with 4 days of evolution. It often manifests with acute respiratory failure, in some cases making invasive mechanical ventilation (IMV) necessary. Re-expansion pulmonary edema (RPE) is a rare clinical condition with a low incidence rate, which normally occurs with the rapid expansion of the collapsed lung after drainage of the pleural cavity.
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