Spontaneous pneumothorax secondary to tuberculosis

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Hamida Kwas
Ines Zendah
Habib Ghedira

Abstract

Introduction: Spontaneous pneumothorax (SP) is a frequent complication of pulmonary tuberculosis (TB) and a severe form of the disease. In
spite of the fact that TB is a common cause of pneumothorax, a very few series, have been reported. For this reason, we retrospectively analysed
the experience of SP secondary to TB in patients who were hospitalized in our department between 2005 and 2015.
Results: The mean age of patients was 38,5±19 years. Two patients had a history of pulmonary tuberculosis. The chest x-ray showed a
pneumothorax in 5 cases, a hydropneumothorax in 5 cases and cavitary lesions accompanying SP in 5 cases. Acido-alcoolo-resistant bacilli
were isolated in the expectorations in all patients. Treatment associated antitubercular chemotherapy in compliance with the national plan of
struggle against tuberculosis, chest drainage and respiratory physiotherapy. The average duration of chest tube drainage was 23 days. Two
patients underwent surgery. The course was favourable in 5 cases. A delay (>1month) to bacilli negativation was noticed in 2 patients and
pachypleuritis requiring surgical pleural decortications in 2 patients.
Conclusion: In our study, tubercular pneumothorax was always associated with active cavitated tuberculosis. The course was most of the time
favourable with antitubercular chemotherapy and chest drainage. However, pleural sequelae such as pachypleuritis persisted sometimes.

Keywords:

Tuberculosis, Secondary spontaneous pneumothorax, Pleural drainage, Pachypleuritis.

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