• Chu Zhang, Yong Pan, Rui-Mei Zhang, Wen-Bin Wu, Dong Liu, and Miao Zhang.
• Department of Thoracic Surgery, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing.
• Medicine (Baltimore). 2019 Jun 1; 98 (26): e16228.

RationaleLate-onset bronchopleural fistula (BPF) induced by chemotherapy after lobectomy for lung cancer is rarely reported, lacking reliable preventive approaches. A timely identification and individualized treatment is essential for prognosis.Patient ConcernsA 52-year-old female patient complained of fever, productive cough, and fatigue 1 week after adjuvant chemotherapy following right lower lobectomy and systemic mediastinal lymph node dissection. Chest computed tomography (CT) indicated pneumothorax and thick-walled empyema cavity within her right-sided thorax.DiagnosesThe patient was diagnosed as late-onset BPF based on clinical manifestation and chest radiography.InterventionsIn addition to antibiotics, a chest tube was reinserted under CT guidance, and vacuum suction was utilized for continuous drainage. Next cycle of adjuvant chemotherapy was terminated.OutcomesThe empyema cavity was gradually closed in 1 month after conservative treatment, and the patient survived with good condition up to now.LessonsLate-onset BPF should be kept in mind when the patient suffered from productive cough and chills during postoperative chemotherapy. And a prompt conservative management might be effective.

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