Lung function of Malayali youth restored through complex thoracic surgery after prolonged illness abroad
The surgery required multiple blood transfusions and intensive peri-operative monitoring. Soon after the procedure, Ananth was weaned off ventilatory support, resumed oral feeding by evening and was able to walk the next day.
Kochi: IA 20-year-old Malayali student whose lung function had severely deteriorated following a complicated pneumonia while pursuing higher studies in Canada has made a rapid recovery after undergoing a major thoracic surgery at a private hospital in Cochin.
The surgery was conducted at Sunrise Hospital, Kochi.
Ananth Krishna Hareesh, a third-year Mechatronics student at Gregorian College, Barrie, Ontario, developed left-sided chest pain, fever and breathlessness in September 2025 and was admitted to a prominent hospital in Canada. Initial treatment was followed by detailed investigations over the next few days, which revealed multiloculated pleural effusion — a condition in which infected fluid becomes trapped in multiple pockets around the lung.
Partial drainage of the fluid was performed and samples were sent for further testing. As the patient hailed from India, doctors there suspected tuberculosis and placed him in isolation as a precautionary measure. Hospital authorities later confirmed that tuberculosis was ruled out; however, Ananth had by then undergone close to forty days of isolation, with ongoing pain and progressive respiratory distress.
Despite medical therapy and insertion of a chest tube for further drainage, his condition showed little improvement. His lung condition continued to deteriorate, resulting in a substantial loss of functional capacity in two months.
Concerned about his condition, his parents decided to bring him back to Kerala for treatment. He arrived in Kochi on November 18, 2025, and was admitted two days later to the Department of Thoracic Surgery at Sunrise Hospital.
Detailed imaging, including a CT scan of the chest, revealed that the infection had progressed into a complex multiloculated empyema. The fluid had turned into thick pus and subsequently hardened, encasing the left lung in a dense fibrous layer — a condition known as "trapped lung,” in which the lung is unable to expand normally. For all practical purposes, the patient was functioning on a single lung.
"By the time the patient reached us, the infection had organised extensively. The left side of the chest had visibly reduced in size, and the lung was completely compressed by hardened infected material,” said Dr. Nasser Yusuf, Minimally Invasive Cardio Thoracic surgeon who led the surgical team.
Within 24 hours of admission, Ananth was taken up for surgery. The procedure, which lasted close to nine hours, revealed that the hardened pus had formed a solid mass resembling a block of cement measuring approximately 15 × 12 × 4 cm. The mass was densely adherent to the chest wall, diaphragm and adjacent structures, trapping the lung and preventing expansion.
"The infected tissue had to be removed millimeter by millimeter. The procedure involved extensive pleurectomy and decortication, careful control of bleeding, and repair of air leaks from the lung surface,” Dr. Yusuf said. Dense adhesions between the lower part of the lung, chest wall and diaphragm were also meticulously separated to restore lung mobility.
The surgery required multiple blood transfusions and intensive peri-operative monitoring. Soon after the procedure, Ananth was weaned off ventilatory support, resumed oral feeding by evening and was able to walk the next day.
Subsequent investigations confirmed that the condition was caused by a complicated bacterial pneumonia and that there was no evidence of tuberculosis or malignancy ( Cancer).
"The emphasis after surgery was on early mobilisation and aggressive physiotherapy to help the lung re-expand and regain function,” the treating team said.
Prior to surgery, Ananth struggled to climb even a single flight of stairs due to breathlessness. At the time of discharge, just a week after surgery, he had recovered sufficiently to climb up to seven floors comfortably, Hospital authorities said.
The treatment involved a collaborative team including anesthesiologist Dr. Shaji P G, cardiologist Dr. Prashant Gangwar, pulmonologists Dr. Neethu Thampi and Dr. Parvathi S. Pillai, physician Dr. Ranjini Kurian, intensivist Dr. Jithin Jose, physiotherapist Sijo Joy, and thoracic surgery manager Basil Eldhose.
Doctors said that the case highlighted a growing lack of awareness about the seriousness of lung-related complications following pneumonia and the need for timely, accurate diagnosis.
"Persistent chest pain, fever or breathlessness after pneumonia should never be ignored or treated casually. If infected fluid in the chest is not identified and managed early, it can organise, harden and trap the lung, turning a treatable condition into a complex surgical problem,” said Dr. Nasser Yusuf. He added that early imaging, specialist referral and close follow-up are crucial in preventing long-term lung damage.
Ananth has now been declared medically fit to travel and is expected to return to Canada shortly to resume his studies.
Team from Sunrise hospital represented by Pulmonologist Dr. Neetu Thampi, ; Dr. Nasser Yusuf, Minimally Invasive Thoracic Surgeon and Dr. Shobha. P Medical Superintendent; student Ananth Krishnan and parents Dr. Poornima T. A.( Mother) and Harish B ( Father) attended the press meet.
Medical Explainer
What is Empyema and "Trapped Lung”?
Empyema
Empyema is a serious complication of pneumonia in which infected fluid (pus) accumulates in the pleural space — the thin cavity between the lung and the chest wall. In early stages, the fluid may be free-flowing and can often be drained using a needle or chest tube.
If diagnosis or treatment is delayed, the infection can organise into multiple compartments (multiloculated empyema), making simple drainage ineffective. Over time, the infected fluid thickens and may harden, forming a dense layer around the lung.
Trapped Lung
A "trapped lung” occurs when this chronic infection leads to the formation of a thick, fibrous peel around the lung, preventing it from expanding normally during breathing. As a result, the lung remains compressed, causing persistent breathlessness, chest pain and reduced exercise tolerance. In advanced cases, the affected side of the chest may even shrink in size.
Why Surgery Is Needed
Once the lung becomes trapped, medications and tube drainage alone are usually insufficient. Surgical removal of the fibrous layer (decortication and pleurectomy) is required to free the lung and allow it to re-expand. These procedures are complex and require specialised thoracic surgical expertise, especially when the infected tissue is densely adherent to the chest wall, diaphragm or vital structures.