[A case of post-tuberculosis chronic empyema with effective low-dose, long-term clarithromycin administration]

A 78-year-old woman with post-tuberculosis chronic empyema who underwent unsuccessful decortication in July 1993, was admitted to our hospital in November 1994 because of M. tuberculosis in her sputum. One month after anti-tuberculosis treatment, the M. tuberculosis disappeared from the sputum, but a pleurocutaneous fistula that exuded abundant bloody pus containing Pseudomonas aeruginosa persisted in the area of chronic empyema. In July 1997, 200 mg of clarithromycin (CAM) was administered daily; 21 months later, the pus and pleurocutaneous fistula had disappeared. Post-tuberculosis chronic empyema with a fistula is generally an intractable condition that necessitates surgery. In this case, the empyema did not improve during the 4 years after the surgery. However, low-dose, long-term CAM administration brought about a disappearance of pus from the fistula and closure of the empyema spaces.