Pyo-Pneumothorax in Patients with Active Pulmonary Tuberculosis: An Analysis of 17 Cases without Intrapleural Fibrinolytic Treatment

Abstract

Objective: To review the medical records of patients with active pulmonary tuberculosis (TB) and pyo-pneumothorax (PPT). Subjects and Methods: Medical records of 17 patients (14 male, 3 female, mean age 23.8 years, range 20–52) with PPT and active pulmonary tuberculosis at Gulhane Military Medical Academia Haydarpasa Training Hospital, Istanbul, Turkey, were reviewed from January 1998 to December 2002. The patients were treated with chest tube drainage and chemotherapy. Intrapleural fibrinolytic agents or irrigation was not performed. Results: Pleural fluid samples were available in 14 patients and the mean levels of LDH, protein and glucose in the pleural fluid were 1,767 ± 944 U/l, 5.2 ± 1.4 g/dl and 31.7 ± 22.6 mg/dl, respectively. Mycobacterium tuberculosis was detected in the pleural effusion of 3 patients. The duration of chest tube drainage was longer in cases who underwent open drainage (p = 0.014). At the end of the treatment period 10 patients developed pleural thickening, 4 of them underwent decortication and pneumonectomy was also done in 1 patient. The development of pleural thickening was related to the level of pleural fluid glucose (p = 0.04). Conclusion: This study shows that while taking care of patients with pulmonary TB the physician must be aware of the complication of PPT and that adequate chemotherapy and drainage must be duly performed.

Neumotórax espontáneo secundario a tuberculosis pulmonar activa de reciente diagnóstico

“…pleural (8,9,11) . En la tuberculosis pulmonar activa, el pioneumotórax es una complicación que puede ocurrir antes y durante el tratamiento antituberculoso; se encuentra asociado con riesgo alto de morbimortalidad (18,19) .…”

Pyopneumothorax Secondary to Pulmonary Tuberculosis Superadded by Congenital Factor XIII Deficiency: A Case Report

“…They contribute significantly to the morbidity and mortality in such complicated cases. As evident by the name, pyopneumothorax is characterized by both pus and gas in the pleural space [3]. Factor XIII deficiency is a rare bleeding disorder with a difficult clinical diagnosis.…”

Tuberculous Pyopneumothorax as A Complication of Inadequate Treatment in Active Pulmonary Tuberculosis: A Case Report

“…P n e u m o t h o ra x , e m p y e m a , a n d pyopneumothorax are complications of pulmonary tuberculosis (TB), whilst infrequent but leading to significant morbidity and mortality 1,2 . Tuberculous pleural effusion originates from infection of the pleura by Mycobacterium tuberculosis which is characterized by fluid accumulation and the presence of chronic inflammatory cells in the pleural cavity 3 .…”