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Case Reports
. 2023 Sep 1;62(17):2527-2529.
doi: 10.2169/internalmedicine.0922-22. Epub 2023 Feb 1.

Hyperammonemia Due to Empyema

Hiroshi Wada  1 , Miyuki Goto  1 , Masashi Misonou  1
Affiliations
Case Reports

Hyperammonemia Due to Empyema

Hiroshi Wada et al. Intern Med. .

Abstract

A 91-year-old woman was brought to our hospital with altered consciousness. Blood tests showed an increased ammonia level of 468 μg/dL and a normal liver function. Chest computed tomography showed massive right pleural effusion with loculation. We immediately performed chest drainage using two drainage tubes. The pleural effusate pH was 8.5. We diagnosed her with right empyema leading to hyperammonemia and initiated ampicillin/sulbactam therapy. However, she developed progressive renal failure and died on the third day. Empyema caused by urease-producing bacteria can lead to hyperammonemia. This is the first report of hyperammonemia due to empyema in the English literature.

Keywords: altered consciousness; empyema; hyperammonemia.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
Chest X-ray on admission showed massive, loculated, right-sided pleural effusion.
Figure 2.
Figure 2.
Chest computed tomography at the first visit confirmed massive, loculated, right-sided pleural effusion as well as a collapsed right lung.
See this image and copyright information in PMC

References

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