Giant Fluid-Filled Bulla Treated by Instillation of Antibiotics after Percutaneous Drainage

Abstract

A 46-year-old man was admitted 3 years ago with symptoms of right chest discomfort. A chest X‐ray and CT scan revealed an air-fluid level in a previously diagnosed giant bulla in his right upper lung field. Percutaneous drainage of the giant fluid-filled bulla using a pigtail catheter was performed. Instillation of antibiotics was performed twice and the catheter was removed. Two years later almost complete disappearance of the cavity was noted. Although immediate resolution of the giant fluid-filled bulla was not obtainable, the infection was controlled and an invasive procedure avoided.

Key words

Fluid‐filled bulla - percutaneous drainage - antibiotic instillation

References

• 1 Mahler D A, D'Esopo N D. Periemphysematous lung infection.  Clin Chest Med. 1981;  2 51-57
• 2 Leatherman J W, McDonald F M, Niewoehner D E. Fluid-containing bullae in the lung.  South Med J. 1985;  78 708-710
• 3 Hata Y, Takagi K, Sasamoto S et al. Infected giant bulla treated by percutaneous drainage followed later by resection: report of a case.  Surg Today. 2007;  37 656-659
• 4 Dean N C, Stein M G, Stulbarg M S. Percutaneous drainage of an infected lung bulla in a patient receiving positive pressure ventilation.  Chest. 1987;  91 , [A]: 928–930
  
• 5 Kirschner L S, Stauffer W, Krenzel C, Duane P G. Management of a giant fluid-filled bulla by closed-chest thoracostomy tube drainage.  Chest. 1997;  111 1772-1774
• 6 Clagett O T, Geraci J E. A procedure for the management of postpneumonectomy empyema.  J Thorac Cardiovasc Surg. 1963;  45 141-145