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Intrapleural Tetracycline Therapy

Gary N. Fox, MD
JAMA. 1979;242(13):1362. doi:10.1001/jama.1979.03300130016010.
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To the Editor.—  Goldszer et al (241:724, 1979) reported a case of spontaneous pneumothorax with persistent leak treated with intrapleural instillation of tetracycline. This technique was based on the work of Wallach,1 who has since amended his method of chemical pleurodesis. The modified regimen involves adding 15 mL of 1% lidocaine hydrochloride to the tetracycline solution before instillation. The lidocaine reduces the discomfort and usually eliminates the need for narcotic analgesics. I have been involved in a case of bilateral pleural fibrosis where therapy with tetracycline was employed, using lidocaine in one pleural space but not the other.

Report of a Case.—  A 62-year-old woman admitted to the hospital for a right pleural effusion was found to have adenocarcinoma of the ovary with Meigs' syndrome. Evaluation procedures included exploratory laparotomy. Before surgery a chest tube was placed in the right pleural space, and because of continued drainage after surgery,

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