A 68-Year-Old Woman With a Rapidly Reaccumulating Pleural Effusion

A 68-year-old woman presented with worsening dyspnea. She had presented to her local community hospital 10 days earlier with similar symptoms. She was diagnosed with a right-sided pleural effusion, which was attributed to pneumonia and treated with antibiotics. She underwent two thoracenteses within a week, with relief of dyspnea after each procedure. Two days after hospital discharge, she developed recurrence of dyspnea and presented to our hospital. She denied any cough, fever, chills, or night sweats. She denied leg swelling, orthopnea, or paroxysmal nocturnal dyspnea. She did not have any recent surgeries or trauma. She had a medical history notable for Hodgkin lymphoma treated with radiation 40 years ago, renal cancer treated with nephrectomy, COPD on chronic 2 L oxygen nasal cannula, and pulmonary embolism on chronic anticoagulation. She also had a chronic left-sided chest port, which had been placed for a long-standing history of difficult IV access.