Explosive Pleuritis

Pleural effusions associated with pneumonia (parapneumonic effusions) are one of the most common causes of exudative pleural effusions in the world. Approximately 20 to 40% of patients hospitalized with pneumonia will have an accompanying pleural effusion. The term 'Explosive pleuritis' was originally described by Braman and Donat in 1986 as pleural effusions developing within hours of admission. We report a 38 years old male patient with minimal pleural effusion which progressed rapidly within one day to involve almost whole of the hemithorax. There were multiple loculations on ultrasonography of thorax. Pleural fluid was sero-sanguinous and revealed gram positive diplococcic. The patient improved with antibiotics and pigtail catheter drainage.