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Ann Thorac Surg 2002;74:257-258
© 2002 The Society of Thoracic Surgeons

Case report

Acute respiratory failure after pleurodesis with doxycycline

Daniel J. DiBardino, MD*a, Jason M. Vanatta, MDa, Shawn P. Fagan, MDa, Samir S. Awad, MDa

a The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA

Accepted for publication October 20, 2001.

* Address reprint requests to Dr DiBardino, 6540 Bellows Lane, Apartment 603, Houston, TX 77030 USA
e-mail: ab9088{at}hotmail.com

Bedside pleurodesis through a tube thoracostomy has been shown to be effective treatment of malignant pleural effusion and pneumothorax with persistent air leak. A variety of agents can be used, and each has been shown to produce rare but potentially serious complications. We report a case of sudden, severe respiratory failure in a 42-year-old man after pleurodesis with 300 mg of doxycycline. His response was consistent with an anaphylactic reaction. After intubation, mechanical ventilation and nebulizer treatments, he rapidly recovered to baseline. On the basis of this report and a review of the literature, we believe that doxycycline may not be an innocuous agent for bedside pleurodesis and that such procedures warrant a monitored setting.




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