Authors
Sujana Balla MBBS, Dharani Narendra MD, Kalpalatha Guntupalli MD
Baylor College of Medicine, Houston, TX
Case
A 76-year-old Hispanic female with no significant past medical history was brought to the Emergency Department (ED) with four weeks of progressive fatigue, shortness of breath and subjective fevers with chills. In the ED, she was noted to be tachypneic and hypotensive. An emergent right internal jugular central line was placed. The patient was admitted to the medical intensive care unit for multifocal pneumonia and septic shock. As shock resolved on day 3, the central line was removed and a PICC line was placed due to difficult access. A slow but continuous serosanguinous discharge was noted from the central line insertion site which later became serous and yellowish as shown in image 1. Serial drainage became progressively cloudy and milky as shown in image 2.
Question
What is the cause of this finding?
A. Hemothorax
B. Iatrogenic
C. Malignancy
D. Empyema
