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A Symphony of Challenges: Multi-Drug Resistant Tuberculosis, Pleurocutaneous Fistula, and Empyema Necessitans in
Kamran Ahmad1, Adeel Khan2,3, Amna Yaseen4
1Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
Abstract:
This case report details the clinical course of a 37-year-old male with multi-drug-resistant tuberculosis (MDR-TB) who initially presented with respiratory symptoms. Following a month of anti-TB therapy, the patient developed a painful chest swelling, diagnosed as empyema necessitans, with a subsequent spontaneous rupture leading to a pleurocutaneous fistula. Despite recommendations for surgery, the patient opted for active surveillance. The follow-up revealed symptom improvement. This case underscores the unique challenges of managing rare complications of MDR-TB, particularly when patients decline surgical interventions. The observed symptom improvement, despite the absence of surgery, illuminates the intricate decision-making process and alternative management strategies involved in addressing such complications, highlighting the complexities inherent in MDR-TB care.
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