Iftifat Sultan, Sadiq M.
Pulmonary Tuberculosis with recurrent Pneumothorax.
Pak J Chest Med Jan ;7(2):21-4.
A young girl of 15 years was admitted with history of high grade fever, weight loss, malaise and shortness of breath for three and a half months duration. On admission she was diagnosed as a case of right sided pneumothorax. She was intubated with underwater seal, she had full expansion in three days and thus the tube was removed. She was readmited with in two weeks of discharge presenting this time with bilateral pneumothorax. She had complete, Lt. sided pneumothorax with small pleural effusion and 30% Rt. Sided pneumothorax which resolved spontanously with in hours of admission without intubation. She was discharged home but presented again with sudden shortness of breath on day 8th of discharge with complete Lt. sided Pneumothorax. As she had a history of first right, later bilateral pneumothoracis this time she was intubated followed by pleurodesis with I gram of tetracycline. She was discharged home after 2 days of pleurodesis and remain healthy since then. Hb 10.7 g/dl with a normal TLC and ESR of 36, urine revealed only trace of albumin, LFTs, Urea and electrolytes were all normal, antibody screen was negative, so were her Hepatitis B & C. Diagnostic pleural aspiration under ultrasound guidance revealed an exudate with 94% lymphocytes, Gram stain and culture as well as AFB smear and culture failed to grew an organism. Bronchoscopy was done, the bronchoalveolar lavage obtained was negative for AFB smear and culture high resolution C.T Scan did not reveal any evidence of bullous disorder, finally open Lung Biopsy was performed from the right lower lobe. Histology was consistent with a chronic ganulomatons disorder. Culture of biopsy grew mycobacterium tuberculosis sensitive to all first line drugs.
PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com