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. 2016:2016:4187108.
doi: 10.1155/2016/4187108. Epub 2016 Jul 31.

Tuberculous Empyema Necessitatis in a 40-Year-Old Immunocompetent Male

Farhang Babamahmoodi  1 , Lotfollah Davoodi  1 , Roya Sheikholeslami  1 , Fatemeh Ahangarkani  1
Affiliations

Tuberculous Empyema Necessitatis in a 40-Year-Old Immunocompetent Male

Farhang Babamahmoodi et al. Case Rep Infect Dis. 2016.

Abstract

Empyema necessitans (EN) is a kind of empyema that diffuses to extrapleural space and can involve chest pain. Tuberculosis (TB) is the most common cause of EN. This disease can be found in both immunocompromised and immunocompetent individuals but is usually seen in the immunocompromised individuals. Because of long duration and ambiguous symptoms of the disease, diagnosis can be hard. The disease can be treated both medically and surgically. Missing the disease can lead to undesirable effects on patient's condition and health care setting. This problem can be seen in endemic area in which controlling of TB is hard. Report of the disease in local health care center for desirable treatment and health maintenance is necessary. We explained a rare case of pulmonary TB in a patient that was healthy in other fields and just showed the minimum systemic symptoms. The patient came with a mass in lower part of back of chest cage, with a mild pain. The imaging survey showed EN. Smear and Ziehl-Neelsen stains from subcutaneous aspiration were positive for TB. This case showed importance of clinical view and awareness of this silent but serious disease in endemic area especially for TB.

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Figures

Figure 1
Figure 1
Elliptical bulge of 8∗4 cm in lower part of back of right hemithorax.
Figure 2
Figure 2
Fibrosis was seen in the apexes especially in the right one.
Figure 3
Figure 3
Parenchymal reticular densities were sign of an active process.
Figure 4
Figure 4
Aspirated fluid.
Figure 5
Figure 5
After 40 days of anti-TB treatment.
See this image and copyright information in PMC

References

    1. Kim Y. T., Han K. N., Kang C. H., Sung S. W., Kim J. H. Complete resection is mandatory for tubercular cold abscess of the chest wall. Annals of Thoracic Surgery. 2008;85(1):273–277. doi: 10.1016/j.athoracsur.2007.08.046. - DOI - PubMed
    1. Aylk S., Qakan A., Aslankara N., Ozsöz A. Tuberculous abscess on the chest wall. Monaldi Archives for Chest Disease. 2009;71(1):39–42. - PubMed
    1. Sahn S. A., Iseman M. D. Tuberculous empyema. Seminars in Respiratory Infections. 1999;14(1):82–87. - PubMed
    1. Chaiyasate K., Hramiec J. Images in clinical medicine. Tuberculosis empyema necessitatis. The New England Journal of Medicine. 2005;352(9, article e8) doi: 10.1056/nejmicm040373. - DOI - PubMed
    1. Senent C., Betlloch I., Chiner E., Llombart M., Moragón M. Tuberculous empyema necessitatis. A rare cause of cutaneous abscess in the XXI century. Dermatology Online Journal. 2008;14(3, article 11) - PubMed

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