Empyema presenting over thirty years after pulmonary tuberculosis

Area of Science:

• Pulmonology
• Infectious Diseases
• Thoracic Surgery

Background:

• Artificial pneumothorax (AP) was an historical treatment for pulmonary tuberculosis.
• Long-term complications of AP, such as empyema, may manifest decades later.
• Chemotherapy was not standard during the era these patients were treated.

Observation:

• Four patients developed empyema 32-53 years post-AP treatment for tuberculosis.
• Radiographic findings were non-specific, complicating diagnosis.
• Identifying the causative organism proved challenging in these cases.

Findings:

• Empyema is a potential late complication of treated pulmonary tuberculosis.
• Non-specific symptoms and radiographic changes warrant consideration of empyema.
• Diagnostic difficulties arise from the absence of a clear pathogen.

Implications:

• Empyema should be suspected in patients with a history of treated tuberculosis experiencing deterioration.
• Antituberculosis chemotherapy may be necessary for late-onset empyema.
• Surgical intervention, like decortication, might be required if infection is not readily identified.