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[Fever, productive cough, chest pain]
R Oertel1, A Overlack, H Vetter
1Medizinische Universitäts-Poliklinik Bonn.
Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|November 20, 1990
Summary
A 27-year-old woman experienced prolonged thoracic pain, cough, and fever. Diagnosis of tuberculous pleurisy was confirmed by pleural biopsy and Mycobacterium tuberculosis detection, leading to rapid symptom resolution with anti-tuberculous therapy.
Area of Science:
- Pulmonology
- Infectious Diseases
- Thoracic Medicine
Background:
- Persistent thoracic pain, productive cough, and fever in a young woman suggested a complex respiratory condition.
- Initial antibiotic therapy with erythromycin failed to resolve the patient's symptoms, including a developing pleural effusion.
Observation:
- Diagnostic workup including microbiology, serology, and bronchoscopy yielded inconclusive results.
- Thoracoscopy revealed epithelioid granulomas in pleural biopsy specimens.
- Pleural fluid culture confirmed the presence of Mycobacterium tuberculosis.
Findings:
- The patient presented with a 10-month history of thoracic pain, cough, and fever, complicated by pleural effusion.
- Despite initial antibiotic treatment, symptoms persisted, necessitating further investigation.
- Diagnosis was established through thoracoscopy-guided pleural biopsy and positive culture for Mycobacterium tuberculosis.
Implications:
- This case highlights the importance of considering tuberculosis in the differential diagnosis of persistent pleural effusions, even with negative initial investigations.
- Prompt initiation of multi-drug anti-tuberculous therapy led to rapid clinical improvement and recovery.
- Emphasizes the diagnostic value of thoracoscopy and pleural biopsy in challenging cases of pleural disease.