Fibrin sheath following pleurodesis.

To cite: Yamane H, Ochi N, Yamagishi T, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2013203047 DESCRIPTION A 63-year-old man was admitted to our hospital with drug-induced interstitial pneumonia. He was treated with corticosteroid and showed a partial decrease in the interstitial shadow. However, secondary pneumothorax was detected on day 28 of the treatment (figure 1A), thoracic drainage catheter was inserted. Although pleurodesis using autologous blood was performed twice, air leakage could not be improved. Therefore, pleurodesis using a 50% glucose solution was performed again, which resolved the pneumothorax with spontaneous tube extraction. Chest CT after spontaneous tube extraction showed an intrathoracic passage route of drainage tube with a fibrin sheath (figure 1B–D). A fibrin sheath is often described as a complication of central venous catheterisation and associated with venous occlusion. In the present case, we speculate that pleurodesis using autologous blood could have been the cause of the intrathoracic fibrin sheath. Learning points