Takashi Eguchi, Keiichiro Takasuna, Yoshiaki Tsuge and Kazuo Yoshida
We herein present a case in which extensive cellulitis occurred following a tube thoracostomy for a gas-forming empyema. A 72- year old man was admitted with a fever and cough. A chest computed tomography revealed a large effusion with an air space in the left pleural cavity. A tube thoracostomy was then performed and purulent fluid was recognized. Administration of flomoxef was started after a tube insertion. On the third hospital day, an area of erythema and tenderness was observed around the chest tube insertion site, and on the following day, this area was seen to spread extensively to the left lateral abdomen and the left leg. Subsequent computed tomography revealed widespread subcutaneous swelling with small amounts of air. Laboratory data suggested that multiple organ failure was in progress due to a severe and extensive cellulitis, and the antibiotic was changed to doripenem. Ten days after, the cellulitis had resolved and the laboratory data showed normal result. He has been followed up in our outpatient clinic with no relapse after six months. Although rare, possible occurrences of cellulitis should be considered as a potential complication resulting from a tube thoracostomy for empyema.
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