The patient is a 65-year-old woman with Dilated Cardiomyopathy secondary to Adriamycin, status post recent admission for increased shortness of breath and left pleural effusion. She returns now with increased cough productive of white phlegm and progressive dyspnea on exertion. Her physical examination revealed Temperature 100.6, Blood Pressure 116/65, Heart Rate 100, Respiratory Rate 18, 02 Saturation 90% on room air. She was started on empiric course of antibiotics including cefotaxime and clarithromycin, in addition to Digoxin 0.25 mg q day, Lasix 80 mg q day, Capoten 50 mg t.i.d., Aspirin one per day, Synthroid 2 gr. per day, Tamoxifen 10 mg b.i.d., Elavil 75 mg q day, K-Dur 1 q day, Biaxin 500 mg p.o. b.i.d., Digoxin 0.125 mg alternating with 0.25 mg q day, Thyroid 2 grains p.o. q day, Coumadin 5 mg p.o. q day, and K-Dur 20 mg p.o. b.i.d., Ambien 10 mg p.o. q h.s. A chest x-ray showed a left pleural effusion which is unchanged, a new right pleural effusion +- consolidation, and a large peripheral, red, right lower lobe opacity, highly suggestive of a right lower lobe pulmonary infarction. She underwent ultrasound guided thoracentesis complicated by a pneumothorax requiring chest tube placement and evaluation of the pleural fluid revealed a transudative effusion with all cultures and cytology remaining negative. She was treated with Ancef for approximately 7 days while the chest tube was in place, and then switched to Adriamycin with good result. She was also started on IV Heparin with achievement of therapeutic PTT prior to switching to oral Coumadin without complications, while lower extremity non-invasives and a cardiac echocardiogram remained negative for deep venous thrombosis and right ventricular thrombus. The patient was discharged to home with followup with Dr. Gunsolus at the Leyer Memorial Hospital.
What is the reason this patient is on ancef
the pleural fluid revealed a transudative effusion with all cultures and cytology remaining negative.