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Empyema necessitans (EN) as a rare complication of tuberculosis – A case report
INTRODUCTION: Empyema necessitans (EN) is an uncommon condition where an intrathoracic empyema extends into surrounding extra-thoracic tissues. This case report presents a rare instance of tuberculous EN in an immunocompetent individual. PRESENTATION OF CASE: We present a case of a healthy young mal...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10694643/ https://www.ncbi.nlm.nih.gov/pubmed/37988789 http://dx.doi.org/10.1016/j.ijscr.2023.109011 |
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author | Jamil, Manahil Mehmood, Muzna Janjua, Fraz Abid Ahmad, Faiza Atiq, Arooj Fatima |
author_facet | Jamil, Manahil Mehmood, Muzna Janjua, Fraz Abid Ahmad, Faiza Atiq, Arooj Fatima |
author_sort | Jamil, Manahil |
collection | PubMed |
description | INTRODUCTION: Empyema necessitans (EN) is an uncommon condition where an intrathoracic empyema extends into surrounding extra-thoracic tissues. This case report presents a rare instance of tuberculous EN in an immunocompetent individual. PRESENTATION OF CASE: We present a case of a healthy young male with complaints of weight loss and a chest wall swelling, initially treated as a subcutaneous abscess. He had a history of TB contact and initial laboratory tests showed elevated CRP and ESR, with no bacterial growth on initial culture from FNAC sample. Subsequent imaging revealed the presence of pleural empyema. Following surgical intervention, a connection between fluid collection outside the thoracic wall and the pleural cavity was identified. Diagnosis of tuberculous EN was made on results of second culture of the fluid collection. The patient was further treated with anti-tuberculous treatment. DISCUSSION: EN, rare extrapulmonary complication of tuberculosis, is challenging to diagnose due to nonspecific symptoms and paucibacillary nature of extrapulmonary TB. Imaging plays a crucial role in diagnosis. A multidisciplinary approach involving surgery and anti-tuberculous treatment is effective in managing EN. CONCLUSION: This case underscores the scarcity of EN occurrences and emphasizes the potential for latent TB to surface as atypical complications. Accurate diagnosis requires a combination of clinical insight, imaging, and laboratory tests. EN should be considered in individuals with chest wall masses, particularly in TB endemic areas, and those with a history of TB contact. Treatment involves surgical intervention and anti-tuberculous therapy. |
format | Online Article Text |
id | pubmed-10694643 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-106946432023-12-05 Empyema necessitans (EN) as a rare complication of tuberculosis – A case report Jamil, Manahil Mehmood, Muzna Janjua, Fraz Abid Ahmad, Faiza Atiq, Arooj Fatima Int J Surg Case Rep Case Report INTRODUCTION: Empyema necessitans (EN) is an uncommon condition where an intrathoracic empyema extends into surrounding extra-thoracic tissues. This case report presents a rare instance of tuberculous EN in an immunocompetent individual. PRESENTATION OF CASE: We present a case of a healthy young male with complaints of weight loss and a chest wall swelling, initially treated as a subcutaneous abscess. He had a history of TB contact and initial laboratory tests showed elevated CRP and ESR, with no bacterial growth on initial culture from FNAC sample. Subsequent imaging revealed the presence of pleural empyema. Following surgical intervention, a connection between fluid collection outside the thoracic wall and the pleural cavity was identified. Diagnosis of tuberculous EN was made on results of second culture of the fluid collection. The patient was further treated with anti-tuberculous treatment. DISCUSSION: EN, rare extrapulmonary complication of tuberculosis, is challenging to diagnose due to nonspecific symptoms and paucibacillary nature of extrapulmonary TB. Imaging plays a crucial role in diagnosis. A multidisciplinary approach involving surgery and anti-tuberculous treatment is effective in managing EN. CONCLUSION: This case underscores the scarcity of EN occurrences and emphasizes the potential for latent TB to surface as atypical complications. Accurate diagnosis requires a combination of clinical insight, imaging, and laboratory tests. EN should be considered in individuals with chest wall masses, particularly in TB endemic areas, and those with a history of TB contact. Treatment involves surgical intervention and anti-tuberculous therapy. Elsevier 2023-11-04 /pmc/articles/PMC10694643/ /pubmed/37988789 http://dx.doi.org/10.1016/j.ijscr.2023.109011 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Jamil, Manahil Mehmood, Muzna Janjua, Fraz Abid Ahmad, Faiza Atiq, Arooj Fatima Empyema necessitans (EN) as a rare complication of tuberculosis – A case report |
title | Empyema necessitans (EN) as a rare complication of tuberculosis – A case report |
title_full | Empyema necessitans (EN) as a rare complication of tuberculosis – A case report |
title_fullStr | Empyema necessitans (EN) as a rare complication of tuberculosis – A case report |
title_full_unstemmed | Empyema necessitans (EN) as a rare complication of tuberculosis – A case report |
title_short | Empyema necessitans (EN) as a rare complication of tuberculosis – A case report |
title_sort | empyema necessitans (en) as a rare complication of tuberculosis – a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10694643/ https://www.ncbi.nlm.nih.gov/pubmed/37988789 http://dx.doi.org/10.1016/j.ijscr.2023.109011 |
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