Destroyed lung complicated with empyema

Case report 76 year old woman who went to her local hospital with fever up to 39°C, brownish expectoration, left chest pain and breathlessness that has been increasing in recent weeks. She had a colostomy as a result of an adenocarcinoma colon intervention 18 years ago. She used wheelchair due to an ischemic stroke with paresis of the left lower limb during the postoperative. She had never smoked. She referred bronchial hyper reactivity, in addition to pleural thickening probably post-tuberculosis. There were no previous reports or studies from the patient due to her changing residence less than a year ago. The patient had no treatment. On examination, the patient presented blood pressure of 120/80 mmHg, heart rate of 80 beats per min and basal saturation of 90%. Cervical, hemifacial, chest and left upper limb slight subcutaneous emphysema. Pulmonary auscultation showed left hemithorax hypophonesis and vesicular murmur preserved in right hemithorax. Chest radiography has been performed showing left pleural thickening with residual mediastinal shift and apparent absence of left lung parenchyma with air fluid level (FIGURE 1).