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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

Two cases of tuberculosis pleurisy with abscess formation of chest wall by indwelling thoracostomy tube

Kei Nakamura  Tomohiko Ishimine  Natsumi Fukuzato  Noriko Arakaki  Tsutomu Shimoji  Kazunori Tamaki 

Department of Respiratory Medicine, Nakagami General Hospital

ABSTRACT

We here report two cases of tuberculous pleurisy complicated by abscess formation of the chest wall resulting from an indwelling thoracostomy tube. Both patients were diagnosed as having tuberculosis pleurisy by the pathological examination using the procedure of thoracoscopic pleural biopsy. The abscess of the first case was formed after the biopsy, and Mycobacterium tuberculosis was isolated, regardless of using antitubercular agents, from abscess of the chest wall where the thoracostomy tube had been placed. The abscess of the second case protruded into intrapleural space through the chest wall after the treatment of tuberculosis pleurisy. The paradoxical reaction was suspected in this case, since no organisms were isolated from the abscess specimens without additional antitubercular chemotherapy. It should be a concern that patients with tuberculous pleurisy have a risk of abscess formation of the chest wall resulting from placement of thoracostomy tube after thoracoscopic pleural biopsy.

KEYWORDS

Tuberculous pleurisy  Thoracoscopic pleural biopsy  Thoracostomy tube  Chest wall tuberculosis  Paradoxical reaction/response 

Received 10 Sep 2015 / Accepted 1 Apr 2016

AJRS, 5(4): 222-225, 2016

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