Síndrome de Contarini: ¿una entidad olvidada? / Contarini’s syndrome: a forgotten entity?

El síndrome de Contarini es una presentación infrecuente de derrame pleural bilateral en la cual el líquido pleural en cada hemitórax presenta diferentes características, y puede explicarse por diferentes causas. Hay escasa literatura al respecto, por lo que presentamos un caso de derrame pleural bilateral que sería compatible con dicho síndrome (AU)

Contarini’s syndrome is an infrequent presentation of bilateral pleural effusion, in which the pleural fluid in each hemithorax has different characteristics and can be explained by different causes. There is limited literature on this syndrome, so we present a case of bilateral pleural effusion that would be compatible with this syndrome (AU)

Diagnosis and Treatment of Pleural Effusion. Recommendations of the Spanish Society of Pulmonology and Thoracic Surgery. Update 2022

Pleural effusion (PE) is a common yet complex disease that requires specialized, multidisciplinary management. Recent advances, novel diagnostic techniques, and innovative patient-centered therapeutic proposals have prompted an update of the current guidelines. This document provides recommendations and protocols based on a critical review of the literature on the epidemiology, etiology, diagnosis, prognosis, and new therapeutic options in PE, and addresses some cost-effectiveness issues related to the main types of PE. (AU)

A Hydropneumothorax Captured by M-mode Ultrasonography

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Patrón micronodulillar pulmonar bilateral. ¿Variedad de posibilidades? / Bilateral pulmonary micronodulillar pattern: a variety of possibilities?

The bilateral micronodulillary pattern involves multiple diagnostic possibilities that include inflammatory, infectious, neoplastic, interstitial and autoimmune pathologies, among others. We present a clinical case with definitive diagnosis of carcinomatouslymphangitis secondary to pulmonary adenocarcinoma and the different diagnostic tests needed to obtain an accurate diagnosis. (AU)

FluoroType® MTB en líquido pleural para el diagnóstico de tuberculosis / FluoroType® MTB in pleural fluid for diagnosing tuberculosis

Objetivos This work aims to investigate the diagnostic accuracy of a nucleic acid amplification test (FluoroType MTB®) in pleural fluid (PF) and sputum to diagnose tuberculous pleural effusion (TPE). We also analyzed the increase in diagnostic accuracy of a second FluoroType MTB® test on a second thoracentesis sample when the first was negative. Métodos We conducted a prospective single-center study that included 207 patients with pleural effusion (31 tuberculous and 176 due to other causes). Of the 31 cases of TPE, 21 (68%) were confirmed histologically or microbiologically; the other cases were considered probable. Resultados The operational characteristics of FluoroType MTB® in PF for identifying tuberculosis were a sensitivity of 13%, a specificity of 99%, a positive likelihood ratio of 11, and a negative likelihood ratio of 0.9. The diagnostic efficacy data for sputum samples were 21%, 91%, 2.4, and 0.9, respectively. PF and sputum cultures in solid and liquid media had greater sensitivity (36% and 31%, respectively). A second FluoroType MTB® test in PF was negative for 24 patients who had TPE and for whom the first FluoroType MTB® test was also negative. Only two (6.5%) patients with TPE had a confirmed diagnosis based exclusively on the positive results of the FluoroType MTB® in PF. Conclusión Due to its low sensitivity, the FluoroType MTB® test in PF has a limited role in diagnosing tuberculous pleurisy (AU)

Manejo del derrame pleural maligno / Malignant Pleural Effusion Management

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Diagnóstico de hernia diafragmática congénita de presentación tardía mediante ecografía a pie de cama / Diagnosis of a late-onset congenital diaphragmatic hernia using bedside ultrasound

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Mantle Cell Lymphoma - a less frequent presentation

The clinical manifestations of non-Hodgkin's lymphomas (NHL) are unspecific and may vary with their location, growth rate or organs involved. Chylothorax consists of an accumulation of chyle in pleural space. galiLymphoproliferative diseases represent the main non-traumatic aetiology. The authors report the case of an 81-year-old woman admitted with right pleural effusion and lower limbs oedema, initially interpreted as decompensated heart failure. The thoracocentesis revealed a chylothorax and the aetiological study exposed a mantle cell lymphoma. The authors aim to alert to a less frequent presentation of NHL and remind that a low suspicion may delay the diagnosis

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El taponamiento torácico como desafío diagnóstico / Thoracic tamponade: as a diagnostic challenge

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Síndrome de pulmón encogido y derrame pleural como manifestación inicial de síndrome de Sjögren primario / Shrinking lung syndrome and pleural effusion as an initial manifestation of primary Sjögren's syndrome

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Pleuritis por Cryptococcus neoformans en paciente inmunocompetente / Cryptococcus neoformans pleuritis in an immunocompetent patient

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Quilotórax a tensión en postoperatorio tardío de neumonectomía izquierda / Tension chylothorax in the late postoperative period of left-sided pneumonectomy

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Fístula biliopleural tras colecistecomía laparoscópica en un paciente nonagenario / Biliopleural fistula after laparoscopic cholecystectomy in a nonagenarian patient

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Nocardiosis diseminada de evolución fatal por Nocardia otitidiscaviarum / Disseminated nocardiosis secondary to Nocardia otitidiscaviarum infection with fatal outcome

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Yellow Nail Syndrome: A Rare Cause of Pleural Effusion / Síndrome de las uñas amarillas: una causa rara de derrame pleural

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Toracocentesis en Atención Primaria / Thoracentesis in Primary Care

La toracocentesis es una prueba sencilla y con escasas complicaciones que aporta información relevante en el diagnóstico de un derrame pleural, a través de una correcta interpretación del análisis del líquido pleural. Una iniciativa interesante sería incorporar esta técnica a aquellos equipos de Atención Primaria que atienden a pacientes graves y complejos con dificultades para el desplazamiento a centros especializados distantes de sus domicilios. En este contexto, un buen conocimiento de las posibilidades diagnósticas que ofrece el análisis del líquido pleural podría ser de gran utilidad, en manos de personal bien entrenado, para establecer la etiología de un derrame pleural e iniciar, con la mayor celeridad posible, su tratamiento. Este artículo trata de contribuir a ello, trasmitiendo unas pautas de cómo una técnica sencilla puede aportar información relevante para conocer la etiología del derrame pleural y que podría implementarse en un determinado marco de Atención Primaria

Thoracentesis is a simple test with few complications that provides relevant information in the diagnosis of a pleural effusion, through a correct interpretation of the pleural fluid analysis. An interesting initiative would be to incorporate this technique by those Primary Care teams that treat serious and complex patients, with difficulties in moving to specialised centres far from their homes. In this context, a good knowledge of the diagnostic possibilities offered by the pleural fluid analysis could be very useful in the hands of well trained staff to establish the aetiology of a pleural effusion and be able to initiate, as quickly as possible, its treatment. This article aims to contribute to this, by suggesting guidelines on how a simple technique can provide relevant information in order to determine the aetiology of pleural effusion, and which could be implemented within a given Primary Care framework

Patrón micronodulillar pulmonar bilateral. ¿Variedad de posibilidades? / Pulmonary bilateral micronodulillar pattern. Differential diagnosis?

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Cistatina C en el derrame pleural / Cystatin C in Pleural Effusion

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