TY - JOUR T1 - A 76-year-old lady with chronic cough and a discharging chest wall sinus JF - Thorax JO - Thorax SP - 733 LP - 733 DO - 10.1136/thoraxjnl-2011-200109 VL - 66 IS - 8 AU - Mandar Deshpande AU - Ajay Kamath AU - Kieren Allinson AU - Danielle Peat AU - Wyn Parry Y1 - 2011/08/01 UR - http://thorax.bmj.com/content/66/8/733.abstract N2 - A 76-year-old lady was referred to the respiratory clinic with a 6-month history of a discharging left chest wall sinus. She also had a 6-month history of dry cough, left chest wall pain and breathlessness. There was no history of fever, haemoptysis, weight loss or night sweats. She was a lifelong non-smoker and there was no history of asbestos exposure.Investigations showed elevated white blood cell count of 14.5×109/l (neutrophil count 11×109/l) and C reactive protein 87 mg/L; renal and liver function tests were normal. Sputum cultures were negative.She had a laparoscopic Nissen fundoplication 12 years earlier, complicated by perforation of the oesophagus. Subsequently, 6 years later, she developed dyspnoea; a chest x-ray at this time revealed a left-sided pleural-based abnormality. A thoracoscopic biopsy suggested benign pleural thickening/fibrosis. After thoracoscopy, she developed a discharging sinus around the access port site, which was excised.The patient then relocated to the region and presented with a persistent discharge from the original chest wall sinus. Oral penicillin was … ER -