Re-expansion Pulmonary Edema Following Medical Thoracoscopy in Patients with Tuberculous Pleural Effusion

Medical thoracoscopy (MT) procedures are witnessing increased use worldwide as a minimally-invasive modality offering simultaneous diagnostic and therapeutic benefits to patients with unexplained pleural effusions.Re-expansion pulmonary edema (REPE) is a rare but potentially life-threatening complication associated with pleural effusion drainage that can happen following MT.Little is known about the incidence, risk factors or management strategies of REPE post-MT.We report here on the largest case series to date involving three patients with tuberculous pleural effusion (TPE) who developed REPE after MT.All three patients responded well to supportive measures, including oxygen therapy, intravenous diuretics and hydrocortisone.We believe this case series and literature review serve to highlight an uncommon but dangerous complication of MT.Early recognition, followed by prompt treatment of REPE can ensure a better clinical outcome.