Protracted tuberculous empyema necessitans following intercostal drainage tube insertion
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Date
2023-07
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Medip Academy
Abstract
Empyema necessitans (EN) is a rare long-term sequela of poorly or untreated empyema thoracis, characterized by the dissection of pus through the soft tissues and skin of the chest wall, ultimately forming a fistula between skin and pleural cavity. We herein present a male patient in his late 30s, a known case of tuberculosis (TB) on anti-tubercular therapy (ATT) under directly observed treatment short-course (DOTS), who recently came with complaints of backache for 3 days. Chest X-ray showed a massive pleural effusion, in view of which an intercostal drainage tube (ICD) was inserted and 1.5 L of pleural fluid was drained. An ultrasound (USG) back done revealed subcutaneous collection with communication to pleural space, which resolved after pleural fluid drainage. As there was a persistent communication between pleural space and right-sided subcutaneous plane with a massive effusion i.e., EN, he was advised to undergo thoracotomy with decortication and resection of communication which he underwent successfully. This case is presented for its rarity with atypical presentation.
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Keywords
EN, Pleural effusion, TB, ICD
Citation
Kohli S., Agrohi J., G. K. A., Agrohi D.. Protracted tuberculous empyema necessitans following intercostal drainage tube insertion. International Journal of Research in Medical Sciences. 2023 Jul; 11(7): 2722-2725