The adverse effects of fluoroquinolones are yet to be fully elucidated. We present an interesting case of a 41-year-old male with binocular diplopia most likely induced by the use of a fluoroquinolone antibiotic.
A patient with a paraneoplastic effusion presented with respiratory distress one hour after a 2 500 ml pleural aspiration performed at noon. A chest X-ray shows signs of unilateral pulmonary oedema. Re-expansion pulmonary oedema is a rare complication. Oxygen therapy is usually sufficient. It is advisable not to perform this procedure outside normal hours and to withdraw a maximum of 1 500 ml at a time.
VIGNETTE CLINIQUEUn patient de 70 ans, connu pour un sarcome à cellules fusiformes de la cuisse gauche métastatique et en progression, est hospitalisé pour le drainage d'un épanchement pleural gauche. Une première ponction pleurale est effectuée et permet le retrait de 1750 ml de liquide dont l'origine retenue est paranéoplasique. Une récidive de l'épanchement est constatée après 5 jours déjà et il est décidé de mettre en place un drain tunnelisé (PleurX 15,5F) en radiologie interventionnelle. Sa pose a lieu à 12 h 10. De retour dans sa chambre à 13 h 30, le patient décrit une augmentation crescendo d'une dyspnée, apparue 10 minutes après la mise en place du drain. Il est tachypnéique à 30/min et la saturation est de 69 % à l'air ambiant. À 13 h 40, on constate que le volume drainé via le drain pleural est de 2500 ml, le drain est clampé. La radiographie du thorax montre un oedème pulmonaire gauche. Le diagnostic retenu est un oedème pulmonaire de réexpansion (OPR) secondaire au drainage de l'épanchement pleural. L'évolution est rapidement favorable sous oxygénothérapie seule.
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