https://scholars.lib.ntu.edu.tw/handle/123456789/562482
Title: | Recurrent bilateral pneumothoraces: A rare complication of miliary tuberculosis | Authors: | Liu W.-L. HAO-CHIEN WANG KWEN-TAY LUH PAN-CHYR YANG |
Issue Date: | 2008 | Journal Volume: | 107 | Journal Issue: | 11 | Start page/Pages: | 902-906 | Source: | Journal of the Formosan Medical Association | Abstract: | Pneumothorax as a complication of adult cavitary pulmonary tuberculosis is well known and not at all rare, but its occurrence as a complication of miliary tuberculosis is extremely rare. We report a 22-year-old woman who had nonproductive cough and fever for 3 days. Chest radiography showed diffuse, symmetrical miliary nodulation throughout both lung fields. The patient was treated for a presumed diagnosis of miliary tuberculosis with standard antituberculous regimen. Bilateral pneumothorax occurred simultaneously during hospitalization and chest tube thoracostomy was performed. Three days later, recurrent right pneumothorax developed. Video-assisted thoracoscopic surgery (VATS) lung biopsy of the right lung was performed and pathology showed granulomatous interstitial pneumonia with acid-fast positive bacilli. Lung tissue culture was positive for Mycobacterium tuberculosis. In the following 2 months, bilateral pneumothorax recurred twice and chemical pleurodesis with minocycline was performed on both sides, but air leakage persisted. VATS pleurodesis was performed on both sides successfully without recurrence of pneumothorax on either side. Our experience highlights the fact that pneumothorax should be suspected in an adult with miliary tuberculosis who suddenly develops acute respiratory distress. Recurrent pneumothorax can be managed, apart from medical therapy of miliary tuberculosis, with surgical intervention. ? 2008 Elsevier & Formosan Medical Association. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/562482 | ISSN: | 0929-6646 | DOI: | 10.1016/S0929-6646(08)60208-9 | SDG/Keyword: | ethambutol; isoniazid; levofloxacin; rifampicin; adult; article; case report; clinical feature; computer assisted tomography; contrast enhancement; coughing; dyspnea; female; fever; histopathology; human; human tissue; image analysis; leukocyte count; lung biopsy; miliary tuberculosis; pleurodesis; pneumothorax; recurrent infection; thorax drainage; thorax pain; thorax radiography; thrombocyte count; treatment duration; treatment response |
Appears in Collections: | 醫學院附設醫院 (臺大醫院) |
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