{"doi":"10.3389/fcimb.2024.1458652","title":"Novel management of pseudomonas biofilm-like structure in a post-pneumonectomy empyema","abstract":"We present a patient with a post-pneumonectomy empyema refractory to surgical debridement and systemic antibiotics. The patient initially presented with a bronchopleural fistula and pneumothorax secondary to tuberculosis (TB) destroyed lung, which required a pneumonectomy with Eloesser flap. Ongoing pleural infection delayed the closure of the Eloesser flap, and thoracoscopic inspection of his chest cavity revealed a green, mucous biofilm-like structure lining the postpneumonectomy pleural cavity. Cultures identified pan-susceptible Pseudomonas aeruginosa. Despite debriding this biofilm-like structure and administering systemic antibiotics, the patient continued to show persistent signs of infection and regrowth of the film. We employed a novel approach to dissolve the biofilm-like structure using intrapleural dornase alfa followed by intrapleural antibiotic washes. After 3 weeks of daily washes, repeat inspection demonstrated the biofilm-like structure had completely resolved. Resolving the pseudomonas biofilm-like structure allowed permanent closure of his chest without further need for systemic antibiotics. At follow up 3 months later, he showed no sequalae. This treatment option can be an important adjunct to improve likelihood of chest closure in patients with post-pneumonectomy empyema that resists standard treatment options due to biofilm formation.","journal":"Frontiers in Cellular and Infection Microbiology","year":2024,"id":476101,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9541,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":455430,"name":"Carolina M. Larrain","orcid":"0009-0009-4773-2632","position":1,"is_corresponding":false},{"id":1313738,"name":"L Friedman","orcid":null,"position":2,"is_corresponding":false},{"id":1313739,"name":"Rachel Repkorwich","orcid":null,"position":3,"is_corresponding":false},{"id":1087397,"name":"Ifeanyichukwu U. Anidi","orcid":"0000-0002-2692-1225","position":4,"is_corresponding":false},{"id":300659,"name":"Karen Forrest","orcid":"0000-0002-9484-0830","position":5,"is_corresponding":false},{"id":354196,"name":"Kevin P. Fennelly","orcid":"0000-0001-9416-0686","position":6,"is_corresponding":false},{"id":927869,"name":"Shamus R. Carr","orcid":"0000-0002-7958-3493","position":7,"is_corresponding":false},{"id":1313367,"name":"A. Gustafson","orcid":"0000-0003-4676-2097","position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-19T02:06:25.428435Z","pmid":"39483118","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}