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Related Experiment Videos

Tuberculous empyema.

S A Sahn1, M D Iseman

  • 1Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology, Medical University of South Carolina, Charleston 29425, USA.

Seminars in Respiratory Infections
|April 10, 1999
PubMed
Summary
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Tuberculous empyema is a rare, chronic pleural infection with many tubercle bacilli, distinct from typical tuberculous pleural effusions. Diagnosis and treatment involve drainage, chemotherapy, and potentially complex surgery for trapped lungs.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Thoracic Surgery

Background:

  • Tuberculous empyema is a chronic, active infection of the pleural space, distinct from common tuberculous pleural effusions.
  • It involves a high burden of tubercle bacilli and can remain asymptomatic for years.

Observation:

  • Patients often present with bronchopleural fistula or empyema necessitatis.
  • Computed tomography reveals characteristic findings like a thick, calcific pleural rind and rib thickening surrounding loculated fluid.
  • Pleural fluid is purulent and smear-positive for acid-fast bacilli.

Findings:

  • Tuberculous empyema is characterized by a large number of tubercle bacilli in the pleural space.
  • Diagnosis is aided by CT imaging showing specific pleural and rib abnormalities.

Related Experiment Videos

  • Pleural fluid analysis confirms the presence of acid-fast bacilli.

    • Implications:

    • Treatment requires pleural space drainage and antituberculous chemotherapy.
    • Challenges include lung re-expansion difficulties and achieving adequate drug levels in pleural fluid, risking drug resistance.
    • Surgical intervention, if necessary, demands experienced thoracic surgeons due to its complexity.