January 1-December 1, 2016
Background --- Loculated parapneumonic effusions cause increasing morbidity and mortality rate with increasing case fatality rate worldwide. The use of intrapleural administration of recumbinant tissue plasminogen activators (r-TPA) has been a rising trend in other countries. To date, there is no known case of intrapleural thrombolytic therapy that has been reported in the Philippines.
Case --- The management was done in Philippine Heart center with the collaboration of the Interventional Radiology and Adult Pulmonology department on September 2016 with a case of a 60 year-old patient having complaints of exertional dyspnea and easy fatigability. Findings showed recurrent pleural effusion with loculations in the right mid to lower hemithorax. Serial intrapleural administration of r-TPA was given to the patient with daily ultrasound imaging and drainage. Patient had a progressive clinical and diagnostic improvement and was concluded to have responded positively on the treatment provided.
Conclusion --- The use of fibrinolytic agents break loculations to facilitate pleural space drainage.