Cargando…
Nontuberculous mycobacterial infection presenting as empyema and life threatening pneumothorax: A challenging situation in the emergency department
Nontuberculous mycobacterial infection in an immunocompetent young patient complicated with empyema and pneumothorax is rarely reported. A 36-year-old man presented to the emergency department with a history of worsening dyspnea and pleuritic chest pain. The patient had unstable vital signs on prese...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Bloomsbury Qatar Foundation Journals
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614334/ https://www.ncbi.nlm.nih.gov/pubmed/26535176 http://dx.doi.org/10.5339/qmj.2015.8 |
_version_ | 1782396379827535872 |
---|---|
author | Anjum, Shahzad Tahir, Ramsha Pathan, Sameer A. |
author_facet | Anjum, Shahzad Tahir, Ramsha Pathan, Sameer A. |
author_sort | Anjum, Shahzad |
collection | PubMed |
description | Nontuberculous mycobacterial infection in an immunocompetent young patient complicated with empyema and pneumothorax is rarely reported. A 36-year-old man presented to the emergency department with a history of worsening dyspnea and pleuritic chest pain. The patient had unstable vital signs on presentation, and was referred to the resuscitation area on a monitored bed. The patient had a chest x-ray (CXR) performed on a prior occasion at a primary health clinic, revealing pneumothorax and some fluid at the left costophrenic angle. On arrival at the hospital, bedside ultrasound was performed which confirmed the diagnosis of pneumothorax. His vital signs were pulse 153, BP 88/62, RR 50 breaths per minute and his oxygen saturation on air was 92%. Tension pneumothorax was diagnosed based on clinical presentation and given vital signs. It was managed immediately with needle decompression followed by chest tube insertion. The patient improved dramatically after needle decompression with stabilization of vital signs. A CXR was repeated post-needle decompression which showed an incompletely resolved pneumothorax with an increase in the size of the effusion. Iatrogenic haemothorax was a possible explanation for this increase in effusion size. Chest tube was successfully inserted in the fourth intercostal space just anterior to the midaxillary line under full aseptic precautions. The chest tube drained 1.4 liters of blood, which on analysis showed a low pH and elevated adenosine deaminase level. Two out of three sputum samples sent from the medical ward were positive for mycobacteria other than tuberculosis as confirmed on culture. The patient's symptoms improved with percutaneous tube drainage of hemopneumothorax and antituberculous medications. |
format | Online Article Text |
id | pubmed-4614334 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Bloomsbury Qatar Foundation Journals |
record_format | MEDLINE/PubMed |
spelling | pubmed-46143342015-11-03 Nontuberculous mycobacterial infection presenting as empyema and life threatening pneumothorax: A challenging situation in the emergency department Anjum, Shahzad Tahir, Ramsha Pathan, Sameer A. Qatar Med J Case Report Nontuberculous mycobacterial infection in an immunocompetent young patient complicated with empyema and pneumothorax is rarely reported. A 36-year-old man presented to the emergency department with a history of worsening dyspnea and pleuritic chest pain. The patient had unstable vital signs on presentation, and was referred to the resuscitation area on a monitored bed. The patient had a chest x-ray (CXR) performed on a prior occasion at a primary health clinic, revealing pneumothorax and some fluid at the left costophrenic angle. On arrival at the hospital, bedside ultrasound was performed which confirmed the diagnosis of pneumothorax. His vital signs were pulse 153, BP 88/62, RR 50 breaths per minute and his oxygen saturation on air was 92%. Tension pneumothorax was diagnosed based on clinical presentation and given vital signs. It was managed immediately with needle decompression followed by chest tube insertion. The patient improved dramatically after needle decompression with stabilization of vital signs. A CXR was repeated post-needle decompression which showed an incompletely resolved pneumothorax with an increase in the size of the effusion. Iatrogenic haemothorax was a possible explanation for this increase in effusion size. Chest tube was successfully inserted in the fourth intercostal space just anterior to the midaxillary line under full aseptic precautions. The chest tube drained 1.4 liters of blood, which on analysis showed a low pH and elevated adenosine deaminase level. Two out of three sputum samples sent from the medical ward were positive for mycobacteria other than tuberculosis as confirmed on culture. The patient's symptoms improved with percutaneous tube drainage of hemopneumothorax and antituberculous medications. Bloomsbury Qatar Foundation Journals 2015-07-02 /pmc/articles/PMC4614334/ /pubmed/26535176 http://dx.doi.org/10.5339/qmj.2015.8 Text en © 2015 Anjum, Tahir, Pathan, licensee Bloomsbury Qatar Foundation Journals. This is an open access article distributed under the terms of the Creative Commons Attribution license CC BY 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Anjum, Shahzad Tahir, Ramsha Pathan, Sameer A. Nontuberculous mycobacterial infection presenting as empyema and life threatening pneumothorax: A challenging situation in the emergency department |
title | Nontuberculous mycobacterial infection presenting as empyema and life threatening pneumothorax: A challenging situation in the emergency department |
title_full | Nontuberculous mycobacterial infection presenting as empyema and life threatening pneumothorax: A challenging situation in the emergency department |
title_fullStr | Nontuberculous mycobacterial infection presenting as empyema and life threatening pneumothorax: A challenging situation in the emergency department |
title_full_unstemmed | Nontuberculous mycobacterial infection presenting as empyema and life threatening pneumothorax: A challenging situation in the emergency department |
title_short | Nontuberculous mycobacterial infection presenting as empyema and life threatening pneumothorax: A challenging situation in the emergency department |
title_sort | nontuberculous mycobacterial infection presenting as empyema and life threatening pneumothorax: a challenging situation in the emergency department |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614334/ https://www.ncbi.nlm.nih.gov/pubmed/26535176 http://dx.doi.org/10.5339/qmj.2015.8 |
work_keys_str_mv | AT anjumshahzad nontuberculousmycobacterialinfectionpresentingasempyemaandlifethreateningpneumothoraxachallengingsituationintheemergencydepartment AT tahirramsha nontuberculousmycobacterialinfectionpresentingasempyemaandlifethreateningpneumothoraxachallengingsituationintheemergencydepartment AT pathansameera nontuberculousmycobacterialinfectionpresentingasempyemaandlifethreateningpneumothoraxachallengingsituationintheemergencydepartment |