Question: Hi Doctor,

My father has plueral effusion and done all Tests like for TB and Malignancy, one test out of 7 plueral fluid cytology came suspicious of lymphomas. And then PET CT was done to rule out malignancy PET shows chronic infection or inflammation, Biopsy(Vats thorocoscopy) and Branchoscopy done. All were negative and plueral tissue biopsy results also shows chronic inflammation and negative for malignancy. They started with AKT3 even though TB came Negative and he got fever and then they stopped. After 15 days xray shows no or very little effusion. after 1.5 months now again effusion is thre adn again the doctor is starting with Pyzina 750 mg. kindly suggest why and what could be the diagnosis in my fathers case.

Hello Doctor,

I wanted to brief you about my fathers treatment. Initially he was having fatigue and dry cough. Then after he took the chest xray it was all white in the left side. Then he was admitted to the hospital and then fluid was removed around 200 ml each day(unguided throcentesis) started with AKT3 even though the TB came negative. And then he had complications like low BP. And he was having low grade fever after the AKT was started. Next day he got seizures and a MRI CT done which shows grey thing because of the seizures and nothing else. Doctors told everything else is normal in brain MRI and CT scans, prescribed LEvopil and Felicita, stopped with AKT3 medicines. PET was done to rule out malignancy. it came negative for malignancy.(Non FDG avid moderate left plueral effusion with hypermetabolic interstitial thickening, ground glass haziness and atelectasis in lingula and lower lobe of left lung. 2. midly FDG avid mediastinal nodes no other demostratable active disease in the whole body) imaging features suggestive of infective etiology. Pleural fluid cytology: inflammatory infiltrate with predominance of neutrophils.
VAT thorcoscopic biopsy done.Left pleural biopsy showing chronic inflammation with Histiocytes. And then again AKT3 was started (even though it came negative in biopsy for TB) he was getting low grade fever intially like 99 and then 3rd day he got fever spikes. so again AKT was stopped. and gave antibiotics for 5 days and after the fever is reduced his condition was better day by day and then got discharged and asked to come after 15 days with (plueral effusion undiagnosed). after 15 days xray shows no effusion and then Tb skin test was done and it was negative again. some other antibiotics are give (Zenflox and Glevo) and asked us to come after 1 month. This time he ddnt have any fever. after 1 month xray was taken and doctor told effusion is there around 300 ml. Asked to stop all the medicines and continue on Pyzina 750mg and Zanocin, betnesol and some miltivitiamin). I just wanted to know he got fever at the first time on AKT, if it is drug reaction then will he be getting this time again? And why TB medicines are prescribed even though reports says negative. What could be the recurrent effusion reason?What is the diagnosis in my fathers case.

Please note: my father is a diabetic and BP patient from 20 years on diabetic and BP medicines from 20 years)

Kindly advice why is the pleural effusion happened again? How to treat this.

Hello Doctor,

Uploaded the Reports what ever i have with me. I dont have all of the reports at present right now with me. But kindly let me know which reports you need.My main concern is can Malignancy be ruled out based on the VATS biopsy? and as it says chronic inflammation, could you please let me know why does or what does a chronic inflammation is and how does it be treated? Kindly advice.