Tuberculous Empyema Necessitatis with Osteomyelitis, a Rare Case in the 21^st Century
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Empyema necessitatis refers to empyema that extends into the extrapleural space through a defect in the pleural surface. Tuberculous empyema necessitatis is a rare complication of tuberculosis. We experienced a 21-month-old boy with tuberculous empyema necessitatis with osteomyelitis in the right 7^th rib. He presented with a mass on the right lateral chest wall, which was soft and nontender, enlarging for one month. He also had mild fever. The plain radiograph of his chest revealed soft tissue swelling and calcified lymph node on the left axilla, and his PPD skin test was positive. CT scan of the chest showed empyema necessitatis at the right lower chest and upper abdominal walls with osteomyelitis of the right 7^th rib. He did not have concurrent pulmonary tuberculosis. Surgery was performed for diagnosis and treatment. In histopathologic findings, chronic granulomatous inflammation with caseation necrosis was shown and was positive for acid fast bacilli stain. In addition, M. tuberculosis complex was found as etiology by polymerase chain reaction. The patient has been treated with anti-tuberculous medication without any specific complication.
Abstract
Empyema necessitatis refers to empyema that extends into the extrapleural space through a defect in the pleural surface. Tuberculous empyema necessitatis is a rare complication of tuberculosis. We experienced a 21-month-old boy with tuberculous empyema necessitatis with osteomyelitis in the right 7^th rib. He presented with a mass on the right lateral chest wall, which was soft and nontender, enlarging for one month. He also had mild fever. The plain radiograph of his chest revealed soft tissue swelling and calcified lymph node on the left axilla, and his PPD skin test was positive. CT scan of the chest showed empyema necessitatis at the right lower chest and upper abdominal walls with osteomyelitis of the right 7^th rib. He did not have concurrent pulmonary tuberculosis. Surgery was performed for diagnosis and treatment. In histopathologic findings, chronic granulomatous inflammation with caseation necrosis was shown and was positive for acid fast bacilli stain. In addition, M. tuberculosis complex was found as etiology by polymerase chain reaction. The patient has been treated with anti-tuberculous medication without any specific complication.
참고문헌 (13)
- Jover F, "Tuberculous empyema necessitatis in a man infected with the human immunodeficiency virus", South Med J, 95, pp.751~752 (2002)
- Freeman AF, "Streptococcus pneumoniae empyema necessitatis", Pediatr Infect Dis J, 23, pp.177~179 (2004)
- Moore FO, "Empyema necessitatis in an infant: a rare surgical disease", J Pediatr Surg, 41, pp.5~7 (2006)
- Baillou, "Libri epidemiorum et ephemeridorum", Paris
- Sindel EA, "Empyema necessitatis", Q Bull Sea View Hosp, 6, pp.1~49 (1940)
- Laënnec RTH, "De l’auscultation médiate, ou, traité du diagnostique des maladies des poumons et du coeur: fondé principalement surce nouveau moyen d’exploration" (1819), Brossou et Chaudé
- Kono SA, "Contemporary empyema necessitatis", Am J Med, 120, pp.303~305 (2007)
- Mehndiratta A, "Empyema necessitans following osteomyelitis of rib", Ind J Tub, 46, pp.45~48 (1999)
- Bishara J, "Osteomyelitis of the ribs in the antibiotic era", Scand J Infect Dis, 32, pp.223~227 (2000)
- Whalen JL, "A histological study of acute hematogenous osteomyelitis following physeal injuries in rabbits", J Bone Joint Surg Am, 70, pp.1383~1392 (1988)
- Tonna I, "A case of empyema necessitatis", Eur J Intern Med, 18, pp.441~442 (2007)
- Centers for Disease Control and Prevention, "Treatment of Tuberculosis, American Thoracic Society, CDC, and Infectious Diseases Society of America", MMWR Recomm Rep, 52, pp.1~77 (2003)
- Ludwig B, "Musculoskeletal tuberculosis", Dis Mon, 53, pp.39~45 (2007)