An elderly lady presented with fever and breathlessness. She had recently been diagnosed with a "chest infection".
There is an effusion seen in the left lower chest. Measurements are shown to assist in aspiration. The videoloop demostrates the multiple septations seen within the fluid.
Pleural effusions can be accurately diagnosed by ultrasound. In addition, ultrasound can assist in diagnostic or therapeutic thoracocentesis by localizing fluid and excluding collapse or consolidation as being the cause for the opacity.
The presence of multiple septations or loculations, in the setting of infection, suggests the effusion is becoming complicated or a frank empyema (as opposed to a simple parapneumonic effusion). Similar appearances can be seen with a haemothorax (distinguished by the clinical setting).
In this case a diagnostic tap was performed which grew S pneumoniae.