Chest
Volume 86, Issue 5, November 1984, Pages 795-797
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Selected Reports
Acute Pneumonitis with Bilateral Pleural Effusion after Talc Pleurodesis

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We describe a patient who developed acute pulmonary distress with bilateral interstitial infiltrates and pleural effusion following talc pleurodesis. Talc particles, obtained by bronchoalveolar lavage, were identified by transmission electron microscopy and chemical analysis. The patient improved with corticosteroid therapy. Acute respiratory failure can be a potential hazard of talc pleurodesis.

Section snippets

CASE REPORT

A 40-year-old woman was admitted to the Intensive Care Unit, in May 1982, because of rapidly progressing dyspnea following talc pleurodesis for recurrent right pleural effusion. In 1971, a complete remission of stage 2 Hodgkin's disease was obtained by chemotherapy and radiotherapy. In 1972, she was treated for radiation-induced pericardial tamponade. She was well during 1972-76, but was hospitalized several times during 1976-81 with recurrent right pleural effusion considered to be secondary

DISCUSSION

The patient just reported presented a distinct and unusual clinical syndrome. A few hours after talc pleurodesis, she developed fever with malaise and dyspnea that was rapidly followed by acute respiratory failure. Chest x-ray film findings consisted of bilateral pleural effusion with interstitial infiltrates. Analysis of arterial blood gas showed compromised gas exchange with severe hypoxemia, and right-sided cardiac catheterization disclosed a slight increase in pulmonary arterial pressure.

ACKNOWLEDGMENT

We are indebted to Dr. V. J. Ferrans for advice and criticism, to Misses M. Grandsaigne and F. Mazin for technical assistance; and to Miss S. Rimbault for assistance in the preparation of the manuscript.

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