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doi:10.1378/chest.06-2843
(Chest. 2007; 131:1567-1569)
© 2007 American College of Chest Physicians
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Elevated Glucose in Pleural Effusion*

An Early Clue to Esophageal Perforation

Khalid F. Almoosa, MD, FCCP; Noel Wardell, MD and Shahrokh Javaheri, MD, FCCP

* From the Department of Internal Medicine, Veterans’ Affairs Medical Center (Drs. Almoosa and Javaheri), Cincinnati, OH; and Kaiser Sunnyside Medical Center (Dr. Wardell), Cincinnati, OH.

Correspondence to: Shahrokh Javaheri, MD, FCCP, Pulmonary Section, 111F, VA Medical Center, 3200 Vine St, Cincinnati, OH 45220; e-mail: javaheri{at}snorenomore.com

Esophageal perforation is a rare cause of pleural effusions that carries with it a high mortality rate if diagnosis is delayed. The chemical characteristics of the pleural effusion include high amylase and low pH levels. However, these variables are nonspecific. We present a case of pleural effusion in a patient with markedly elevated glucose levels from recent cola ingestion as a specific clue to the diagnosis of esophageal perforation.

Key Words: esophageal perforation • glucose • lactobacillus • pleural effusion






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