A 15‐year‐old girl was transferred to our hospital with pleural effusion symptomatology along with respiratory distress (RD), which had occurred on multiple occasions. Her respiratory distress could have been relieved only by repetitive pleural tapping as much as 36 times for the last 3 years at the sequence of every 4 weeks before the actual transfer. She apparently started developing the symptoms 3 years prior to the transfer with increasing shortness of breath (SB), requiring medical assistance and incapacitated her to pursue studies and to accomplish ordinary activities. She had then been on six months of antituberculosis drugs first line regimen twice and had completed the treatment 6 months before the transfer. According to the medical report that accompanied the patient, she was treated for extra‐pulmonary tuberculosis with negative microscopy in accordance with national recommendations after both smear and pleural fluid were negative for Zielh‐Neelsen test, and respiratory symptoms did not resolve after nonspecific antibiotic therapy.
Examination
On examination, weight was 53.2 kg, blood pressure: 100/70 mm Hg, heart rate: 82/min, and respiratory rate: 22/min and 36.5°C. Our clinical assessment confirmed a woody note and silent auscultation on the left thorax. The right thorax presented a normal vesicular breath sound. Haemoglobin was slightly low: 11 g/dL (range: 12‐15), and both hepatitis C antibodies and hepatitis B surfaces antigen were nonreactive. The chest X‐ray and the CT‐Scan revealed a giant mediastinal mass with a collapsed left lung and consolidation. In brief, there was evidence of a large well-defined complex cystic mass lesion involving antero‐superior mediastinum and extending to the left to occupy the entire left hemithorax.
Like
Answers
Save
Share