Contarini's Syndrome: Bilateral Pleural Effusions Due to Different Etiologies

Contarini's syndrome is a condition in which the occurrence of bilateral pleural effusions is attributed to different causes for each side. The decision to perform bilateral thoracentesis can be challenging for clinicians, particularly in elderly patients with multiple comorbidities. A 75-year-old Asian man with a past medical history of dementia and dysphagia presenting with dyspnea was brought to our emergency department. Imaging studies revealed bilateral pleural effusions and multiple costal fractures. The results of bilateral thoracentesis indicated an exudate pleural effusion in the right lung and a hemorrhagic pleural effusion in the left lung. Given the results, we determined the etiology of the right pleural effusion to be a parapneumonic effusion resulting from aspiration pneumonia, while the left hemorrhagic pleural effusion was due to costal fractures. After initiating treatment with antibiotics and placement of bilateral drainage tubes, the patient's condition improved remarkably. This case underscores the importance of considering bilateral thoracentesis, particularly in geriatric patients.