First successful case of chemical pleurodesis with oxytetracycline through Rocket® Pleural Vent™: ambulatory pneumothorax device for pneumothorax.

A 79-year-old woman with asthma and idiopathic pulmonary fibrosis was admitted for a first episode right apical secondary spontaneous pneumothorax. Due to a lack of pleural separation inside the safety triangle, Rocket® Pleural Vent™ was inserted in the second intercostal space, mid-clavicular line, as guided by thoracic ultrasound. Although the lung fully re-expanded the next day, there was persistent air leak and so chemical pleurodesis with oxytetracycline was performed with success. There was no recurrence of pneumothorax and the patient was discharged two days afterwards, and a follow-up X-ray taken eight months later did not reveal any recurrence of the right-sided pneumothorax. This is the first reported case of successful chemical pleurodesis through Rocket® Pleural Vent™ for pneumothorax, which may serve to provide additional alternatives to the management of secondary spontaneous pneumothorax that is indicated for pleurodesis after lung re-expansion.

Delayed recovery from ertapenem induced encephalopathy: case-report and a possible mechanism.

CASE: The objective of this case report is to report a patient with moderate renal impairment who developed ertapenem-induced encephalopathy with delayed recovery of up to 2 weeks despite receiving and appropriately adjusted dosage of ertapenem. The patient was managed conservatively with full recovery. Carbapenem related neurotoxicity most commonly manifests as seizure with an estimated incidence of 3 %. There are increasing reports of encephalopathy being related to ertapenem and most commonly subsides within days and extended recovery of up to 2 weeks have only been reported in patients with end-stage renal failure. CONCLUSIONS: Prolonged ertapenem induced encephalopathy can occur in patients with moderate renal impairment. These patients can be managed conservatively and they should make a complete recovery.