{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:31:52Z","timestamp":1784871112391,"version":"3.55.0"},"reference-count":21,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,3,2]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>Lung ultrasonography is an essential tool in the management of pleural infection. We report the usage of lung point-of-care ultrasound (POCUS) using a handheld ultrasound system (HHUS), which changed the immediate management of a complex pleural effusion.<\/jats:p>\n               <jats:p>A middle-aged diabetic patient presented with fever, dyspnoea and left-sided pleuritic chest pain, suggestive of left pleural infection. Lung POCUS using a HHUS showed a multiloculated pleural effusion with no connections between the locules, and this was confirmed later with CT, along with left empyema necessitans. An upfront video-assisted thoracoscopy was done instead of catheter drainage and intrapleural enzyme therapy. Methicillin-sensitive <jats:italic>Staphylococcus aureus<\/jats:italic> was grown from the drained pus. The patient was subsequently discharged with prolonged antibiotic treatment.<\/jats:p>\n               <jats:p>Lung POCUS by a trained physician is useful in deciding the immediate management of pleural infection. Modern HHUS provides a practical and reliable method for identifying and characterising pleural effusion.<\/jats:p>","DOI":"10.1136\/bcr-2024-263279","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T09:41:15Z","timestamp":1741945275000},"page":"e263279","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Could a handheld point-of-care ultrasound system alter the management of patients with pleural infection?"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9976-1509","authenticated-orcid":false,"given":"Wan Aireene","family":"Wan Ahmed","sequence":"first","affiliation":[{"name":"Department of Radiology, Universiti Sains Malaysia Health Campus, Kubang Kerian, Kelantan, Malaysia"},{"name":"Hospital Pakar Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1721-6329","authenticated-orcid":false,"given":"Mohd Jazman","family":"Che Rahim","sequence":"additional","affiliation":[{"name":"Hospital Pakar Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia"},{"name":"Internal Medicine Department, Universiti Sains Malaysia Health Campus, Kubang Kerian, Kelantan, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Faisal","family":"Abdul Hamid","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Universiti Kebangsaan Malaysia, Cheras, Federal Territory of Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,3,14]]},"reference":[{"key":"2025082623105723000_18.3.e263279.1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax-2022-219698"},{"key":"2025082623105723000_18.3.e263279.2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01062-2022"},{"key":"2025082623105723000_18.3.e263279.3","doi-asserted-by":"crossref","first-page":"837","DOI":"10.7863\/jum.2000.19.12.837","article-title":"Sonographic septation: a useful prognostic indicator of acute thoracic empyema","volume":"19","author":"Chen","year":"2000","journal-title":"J Ultrasound Med"},{"key":"2025082623105723000_18.3.e263279.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2009.04.021"},{"key":"2025082623105723000_18.3.e263279.5","doi-asserted-by":"crossref","unstructured":"Said AM , Samra SR , Al Fakharny KM , et al . 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