Profile of tuberculous pneumothorax and comparison with pulmonary tuberculosis without pneumothorax (original) (raw)
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Tuberculous PYO-Pneumothorax: A Rare and Severe form of Tuberculosis
Scholars Journal of Medical Case Reports
Introduction: Tuberculosis is still a public health problem in Morocco. Tuberculous pyopneumothorax is a rare but serious complication secondary to the rupture of a tuberculous cavern in the pleural cavity. It is a well-known clinical form occurring mainly in extensive forms of tuberculosis and in frail patients. In our context, it poses a management problem. We report the case of a young man, chronic smoker, who presented with dyspnea and productive cough revealing a tuberculous pyopneumothorax. Case Report: The patient was a 28 year old male, chronic smoker with 10 PA always active, without any particular pathological history, who had been presenting for 2 months with a productive cough bringing back yellowish sputum with Sadoul stage III dyspnea, and progressive chest pain, all evolving in a context of altered general condition and feverish feeling. The clinical examination found a conscious patient, polypneic at 26 cpm, febrile at 38C°, hemodynamically stable, with objective ple...
Clinical spectrum of pulmonary and pleural tuberculosis: a report of 5,480 cases
European Respiratory Journal, 1996
The aim of the present study was to investigate the epidemiological, clinical, laboratory and radiological features of patients with active pulmonary tuberculosis (TB) (with or without pleural involvement) or with pleural TB (in the absence of radiological parenchymal disease). A systematic predetermined form, including 60 items regarding the above-mentioned features, was completed for 5,480 patients. Sputum smear and culture data, radiological findings, and additional extrapulmonary involvement were evaluated in the patients with pulmonary TB (n=5,094). Epidemiological features, and other clinical and laboratory characteristics were investigated in all patients (n=5,480). TB was more common among persons aged 20-39 yrs, males, and those living in large urban centres in our region. There were 4,268 newly detected patients (78%), and 1,212 active ex-patients (22%) who had history of previous antituberculosis treatment. Additional extrapulmonary involvement was found in 455 patients (9%). Sputum samples were smear-positive in 3,916 (79%), and culture-positive in 3,748 cases (76%). Most common radiological patterns were parenchymal infiltrate in 5,017 (99%), and cavitation in 3,363 (66%). Unusual radiological patterns were also noted, i.e. lower lung field TB (LLFTB) in 317 cases (6.2%), pneumothorax in 78 cases (1.5%), and miliary pattern in 66 cases (1.3%). In conclusion, because of the more frequent occurrence in the younger age group, it is considered that the prevalence of disease is still high and that the transmission of tubercle bacilli is not decreasing in our region. The highest risk group consisted of male subjects and those living in urban centres. The high percentage of active ex-patients suggests that new control programmes for tuberculosis are required in Turkey.
Pneumothorax in active pulmonary tuberculosis: resurgence of an old complication?
Respiratory Medicine, 1998
With the recent resurgence of tuberculosis (TB) in western countries, the incidence of complicating secondary pneumothorax has also increased. The work-up and management of this complication differs from that in other types of secondary spontaneous pneumothorax (SSP). Our objective was to assess clinical features and therapeutic modalities of SSP in patients with and without active pulmonary tuberculosis (APTB). All patients diagnosed with SSP seen at the Hospital Xeral of Vigo from January 1990 to June 1995 were candidates for this study. Full clinical, radiological and microbiological examinations were performed in all patients. Invasive procedures (thoracic catheter aspiration, thoracoscopy and thoracotomy) and mean hospital stay were compared in patients with and without APTB. Forty-eight patients with SSP were enrolled. Eleven patients (10 males and one female, mean age 30 i 11 years) had APTB; and 37 patients (31 males and six females, mean age 49 f 20 years) had conditions other than APTB. Chest pain, cough and fever were more frequent in patients with APTB (90% vs 59%; 45% vs 13.5%; 36% vs 5%, respectively). Catheter aspiration was successful in three of 10 (30%) of patients with APTB and in 15/23 (60.86%) of those without APTB. Catheter aspiration time was longer in the former group (25 * 22 days vs 13 * 11 days, P=O.17). As initial treatment, thoracoscopy was performed in seven of 37 (18.91%) of those without APTB and in one of 10 (10%) patients with APTB. For patients with unsuccessful catheter aspiration, thoracoscopy was performed in eight of nine (89%) patients without APTB and in none of the patients with APTB. Thoracotomy was performed in only one of nine (11%) without APTB and in four of seven (57%) patients with APTB. Patients with APTB had a longer hospitalization (41 vs 18 days, P<O.OOl). We concluded that SSP and APTB was a frequent association in our study. Patients with APTB showed a lesser and slower response to catheter aspiration. Despite severe clinical presentation and demand for more invasive procedures, patients with APTB showed a favourable response.
Pneumothorax occuring during the final stage of treatment in miliary tuberculosis patients
International Journal of Science and Research Archive
Air in the pleural space can cause lung collapse and respiratory discomfort, which can be life-threatening in very ill patients, making pneumothorax a medical emergency. Since tubercle bacilli can travel through the blood to the lungs and other organs, Miliary Tuberculosis (TB) is a disseminated disease that can be lethal. We present a case of a 36-year-old male with Pneumothorax Occuring during the Final Stage of Treatment in Million Tuberculosis Patients. The patient is currently undergoing outpatient treatment of miliary TB for the 11th month and so far his condition is getting better, however was admitted to the emergency unit of the hospital, diagnosed with left pneumothorax based on clinical, laboratory, and radiology showing. In meanwhile, 88% of the room air was saturated with oxygen, necessitating Intensive Care Unit treatment with HFNC FiO2 100 Flow 60, followed by high consentration oxygen therapy with a non-rebreathing mask (NRM) of 15 litres/minute. Combivent inhalation...
Comparative analysis of pulmonary and extrapulmonary tuberculosis of 411 cases
Annals of Clinical Microbiology and Antimicrobials, 2015
Background: Tuberculosis is a disease that can involve every organ system. While pulmonary tuberculosis is the most common presentation, extrapulmonary tuberculosis (EPT) is also an important clinical problem. The current study aimed to outline and compare the demographic and clinical features of pulmonary and extrapulmonary tuberculosis cases in adults. Methods: Medical records of 411 patients (190 women, 221 men) treated between January 2010 and July 2014 in provincial tuberculosis control dispensary was retrospectively reviewed. Demographic and clinical characteristics were compared for pulmonary and extrapulmonary tuberculosis cases. Results: Of these 411 cases, 208 (50.6 %) had pulmonary tuberculosis (PTB) and 203 were diagnosed with extrapulmonary tuberculosis (EPTB) (49.4 %). The average ages for PTB and EPTB groups were 33.00-27.00 and 31.00-29.75, respectively (p = 0.513). Men were more frequently affected by PTB (59.6 %), while EPTB was more commonly detected in women (52.2 %) (p = 0.016). Main diagnostic modalities for PTB were sputum/smear analyses (72.7 %), clinical-radiological data (21.7 %) and biopsy (6.1 %); while biopsy (71.5 %), sputum/fluid analysis (18.8 %) and clinical-radiological data (4.9 %) were used for confirming EPTB (p < 0.0019). The most common sites of EPTB involvement were lymph nodes (39.4 %), followed by pleura (23.6 %), peritoneum (9.9 %) and bone (7.4 %). Conclusıons: Extrapulmonary involvement of tuberculosis is common and females are more likely to be affected. Increased clinical awareness is important since atypical presentations of the disease may constitute diagnostic and therapeutic challenges.
Profile and outcome of unilateral tuberculous lung destruction in Ilorin, Nigeria
West African journal of medicine
Unilateral tuberculous lung destruction is a serious chronically disabling and often fatal complication of pulmonary tuberculosis. A few previous studies have dealt with some aspects of this entity among Nigerians with pulmonary tuberculosis but these studies may not truly reflect its current trends. To describe the presenting profiles and outcome of unilateral tuberculous lung destruction among patients with pulmonary tuberculosis. The study was a chart review of the medical records of adult patients with pulmonary tuberculosis complicated by unilateral lung destruction seen between January 1999- December 2008. Data extracted included demographic, and outcome of treatment. The clinical features, sputum results and illustrative cases are presented. Unilateral lung destruction complicated 74(1.3%) of 5,926 pulmonary tuberculosis cases seen over the review period. Most cases occurred in males [45(60.8%)] and they were predominantly [51(68.9%)] below 40 years of age. Most of them [52(7...
Background: Despite all the advances in the last century, tuberculosis (TB) is still a major problem of public health importance. It is one of the top 10 causes of death worldwide. Material and methods: A retrospective record based study on diagnosed cases of tuberculosis, both pulmonary and extra pulmonary was conducted in a tertiary care hospital of North India for a duration of two and a half years. The information about demographic profile, risk factors, clinical presentation and various diagnostic tests done were obtained from medical case records and analyzed. Results: The study included 230 TB patients. Of these, 82.6% had pulmonary TB and 17.4% had extra pulmonary TB. Male to female ratio was 1.7:1. The number of patients in the age group 20-40 years was greatest. Disseminated TB (30%), abdominal TB (22.5%) and lymphadenitis were the most common form of EPTB. Majority of the cases (74.7%) were from rural areas. History of contact was present in 13% cases. The percentage of smokers and alcoholics in our study was 38.2% and 16% respectively. Diabetes was present in 19.1% patients. Mantoux test was positive in 53% cases and 62.7% were smear positive on ZN staining. Conclusion: TB mostly affects the young and economically productive age group especially from rural areas. It is very important to educate the rural folks about the disease, its mode of spread and create appropriate health care facilities.
Pulmonary tuberculosis presenting as tension pneumothorax
Journal of the Ceylon College of Physicians, 2021
Although detection of spontaneous pneumothorax during evolvement active pulmonary tuberculosis is not uncommon, presentation of pulmonary tuberculosis as tension pneumothorax is rare. There is limited literature regarding pneumothorax complicating pulmonary tuberculosis. Pneumothorax due to tuberculosis can be managed by intercostal drainage in the majority; only a minority needs surgical intervention. Many patients need intercostal drainage for a prolonged period. We report a patient presenting with a tension pneumothorax who was found to have active pulmonary tuberculosis. His pneumothorax was managed successfully with prolonged intercostal drainage. Lessons we learnt during the management of this patient is discussed.
Asian Journal of Biomedical and Pharmaceutical Sciences, 2015
Introduction: Tuberculosis(TB) has always remained a public health challenge despite the availability of effective anti-TB drug therapy under Revised National Tuberculosis Control Programme(RNTCP) in India, for it still causes serious physical, mental suffering and high economic loss by affecting the productive sections of the population. Objectives: The study identifies the epidemiological pattern of Pulmonary Tuberculosis in patients undergoing treatment at Tuberculosis Units (TUs) of Lucknow. Material and methods: The cross sectional study was undertaken to study 400 pulmonary tuberculosis patients by employing a multi-stage sampling technique. Two rural TUs and two urban TUs were studied using Questionnaire method. Results: The study concluded the New cases being the highest category both in rural and urban areas accounting for 71% and 74.5% of all cases respectively. Proportion of Defaulters was more in urban area whereas Relapses was more in rural area. No association was noted with the types of patients with regard to their place of residence (p>0.05). 74.5% patients were sputum positive for acid-fast bacilli and the sputum positivity had a significant statistical association with age group of patients (p<0.04). In all age groups the presenting complaints were cough, fever and expectoration that followed the same descending order. About 77.6% patients had had duration of cough for >5 weeks and 75.7% of patients with expectoration had it for > 5 weeks when medical care was sought. An effort could not find out any statistical association between sputum-smear status and history of smoking or expectoration or haemoptysis. Conclusion: Pulmonary tuberculosis in Lucknow district has showed the usual epidemiological pattern of presentation and sputum positivity had a significant association with age group of the patients.