An unusual case of pediatric shortness of breath—answers

Urinothorax: a systematic review

“…In this regard, of the 12 cases with concordant exudate or LDH-discordant exudate of a known cause, 11 (84.6%) were of traumatic origin. The presence of a concordant exudate does not rule out UT (59,63,66). Hematuria urine can do that the UT is hematic and have high levels of protein due to the passage of plasma to the PF.…”

“…The color of the PE was documented in 33 cases (37.5%): it was straw-colored in 24 (72.7%) and hematic in 9 cases (27.3%). PF odor was only mentioned in 8 case reports (9.1%), described as urinelike or ammoniacal in all cases (5,15,58,63,66,68,75,78). Biochemical characteristics and cellular differentiation of PF were described in only a few cases ( Table 3).…”

“…The question of whether the PE was transudate or exudate was mentioned in 32 reports: 18 were transudate and 14 (43.8%) exudate [3 concordant (59,63,66), 1 protein-discordant (50) and 10 LDH-discordant (15,31,39,57,61,68,72,73,78), according to the classification system of Agrawal et al (82)]. PF/S creatinine ratio was determined in 48 cases (54.5%) and only one (2%) was <1 (0.95) (63). PF culture was performed in 32 cases and proved positive in 3 (9.4%) (5,15,61).…”

“…No direct treatment was applied in 4 patients; 2 with renal stone disease resolved spontaneously (28,39) and the other 2 died (38,48). Finally, the treatment applied in 10 patients was not documented (2,8,10,15,45,52,59,61,63,78).…”

Urinothorax: Case report and systematic review of the literature

“…[ 6 ] Disruption of the urinary tract leads to accumulation of urine in the retroperitoneal space that leaks into the pleural space. [ 5 7 ] It is usually ipsilateral to the lesion side. [ 8 9 ] Diagnosis can be done with renal scintigraphy with a radioactive tracer,[ 10 11 ] or measuring creatinine levels in pleural fluids.…”