[Surgical treatment of tuberculous abscess in chest wall]

A case of chest wall tuberculosis with empyema is reported. A 45-year-old woman with a history of right lung pleuritis was admitted to our hospital with right shoulder pain. The chest X-ray film showed abnormal shadow in the right lower lung field. Chest CT revealed right posterior chest wall abscess and localized empyema. Bacterial examination of the chest wall abscess obtained by needle aspiration biopsy disclosed positive acid-fast bacilli. Three months after starting antituberculous therapy with INH, RFP and SM, the chest wall abscess had been increased and abscess drainage was performed. After two months of tube drainage, the abscess was diminished in size and enucleation with primary closure was performed. Antituberculous chemotherapy was continued. One year after surgery, no sign of recurrence was observed and the residual empyema was decreased.