Fungal empyema in complicated chronic pancreatitis: A rare possibility.

INTRODUCTION: Fungal empyema a rare cause of empyema thoracis is commonly associated with nosocomial infection or gastrointestinal disease with very high mortality. Its association with chronic pancreatitis is rarely been described.

PRESENTATION OF CASE: We present a case of young male known alcoholic with chronic pancreatitis and cystgastrostomy who presented with dyspnea and fever. Thorough workup showed left sided amylase rich loculated pleural effusion. Culture grew candida albicans. Esophagogram carried out for any esophageal rupture turned out to be negative. Histopathology was negative for malignancy. Intraoperative left sided yellowish colour fluid was drained, Loculation broken and rind removed. No pleuro-peritoneal fistula could be identified. Postoperatively patient remained well and discharged on antifungal.

CONCLUSION: No obvious cause of fungal empyema could be found except for pancreatico-pleural spread as suggested by amylase rich pleural effusion along with growth of candida spp. Hence in patient with chronic pancreatitis and cystgastrostomy pleural effusion should be evaluated for fungal infection to avoid morbidity and mortality and commence early treatment.