A rare complication of tuberculosis: chronic empyema thoracis with bronchopleural fistula - a case report

Authors

  • Shaik Ontela Masood Department of Pharmacy Practice, Santhiram College of Pharmacy, Nandyal, Andhra Pradesh, India
  • Guntennagari Supriya Department of Pharmacy Practice, Santhiram College of Pharmacy, Nandyal, Andhra Pradesh, India
  • Ubbara Aswini Department of Pharmacy Practice, Santhiram College of Pharmacy, Nandyal, Andhra Pradesh, India
  • Shaik Muhammad Soheb Department of Pharmacy Practice, Santhiram College of Pharmacy, Nandyal, Andhra Pradesh, India
  • Vemareddy Ahindra Reddy Department of Pharmacy Practice, Santhiram College of Pharmacy, Nandyal, Andhra Pradesh, India
  • Minnalagaari Muhammad Rafi Department of Pharmacy Practice, Santhiram College of Pharmacy, Nandyal, Andhra Pradesh, India
  • Tharun Vinay Gurukul Department of Pharmacy Practice, Santhiram College of Pharmacy, Nandyal, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20250702

Keywords:

Chronic empyema thoracis, Bronchopleural fistula, Tuberculosis, Decortication, Thoracotomy

Abstract

Bronchopleural fistula associated with chronic empyema thoracis is an uncommon and potentially fatal tuberculosis (TB) complication. Bronchopleural fistula remains one of the most serious life-threatening complications but is fortunately rare. We report a case of a 24-year-old male who presented with cough with expectoration, breathing difficulty, pain at right side of chest. Lab investigations and intraoperative findings revealed thickened pleura with calcifications, caseating material, adhesions and fluid build-up with a bronchopleural fistula. The patient underwent surgical decortication of right lung and fistula closure, followed by antitubercular therapy. This case emphasizes how critical it is to identify and treat this uncommon issue as soon as possible. It also underscores the need for a multidisciplinary approach in the treatment of such complex cases. Early treatment is key to reducing the risk of death and other complications.

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References

Biswas A, Jantz MA, Penley AM, Mehta HJ. Management of chronic empyema with unexpandable lung in poor surgical risk patients using an empyema tube. Lung India. 2016;33(3):267-71. DOI: https://doi.org/10.4103/0970-2113.180802

Light RW. Parapneumonic effusions and empyema. Proceed Am Thorac Soc. 2006;3(1):75-80. DOI: https://doi.org/10.1513/pats.200510-113JH

Kim BY, Oh BS, Jang WC, Min YI, Park YK, Park JC. Video-assisted thoracoscopic decortication for management of postpneumonic pleural empyema. Am J Surg. 2004;188(3):321-4. DOI: https://doi.org/10.1016/j.amjsurg.2004.06.009

Gaur P, Dunne R, Colson YL, Gill RR. Bronchopleural fistula and the role of contemporary imaging. J Thorac Cardiovasc Surg. 2014;148(1):341-7. DOI: https://doi.org/10.1016/j.jtcvs.2013.11.009

Weerakkody Y, Farhadi M, Chieng R. Bronchopleural fistula. Radiopaedia. Available at: https://radiopaedia. org/articles/bronchopleural-fistula-2. Accessed on 17 December 2024.

Shen KR, Bribriesco A, Crabtree T, Denlinger C, Eby J, Eiken P, et al. The American Association for Thoracic Surgery consensus guidelines for the management of empyema. J Thorac Cardiovasc Surg. 2017;153(6):e129-46. DOI: https://doi.org/10.1016/j.jtcvs.2017.01.030

Boudaya MS, Smadhi H, Zribi H, Mohamed J, Ammar J, Mestiri T, Kilani T. Conservative management of postoperative bronchopleural fistulas. J Thorac Cardiovasc Surg. 2013;146(3):575-9. DOI: https://doi.org/10.1016/j.jtcvs.2013.04.023

Sokouti M, Sadeghi R, Pashazadeh S, Abadi SE, Sokouti M, Ghojazadeh M, et al. Treating empyema thoracis using video-assisted thoracoscopic surgery and open decortication procedures: a systematic review and meta-analysis by meta-mums tool. Arch Med Sci. 2019;15(4):912-35. DOI: https://doi.org/10.5114/aoms.2018.77723

Hosna AU, Miller D. A case of bronchopleural fistula and hydropneumothorax in a patient with necrotizing pneumonia complicated by Mycobacterium avium complex. Cureus. 2022;14(10):e30280. DOI: https://doi.org/10.7759/cureus.30280

He Z, Shen L, Xu W, He X. An 83-year-old-male with bronchopleural fistula and empyema successfully treated with multidisciplinary management of thoracostomy, endoscopic, and surgical treatment: a case report. Ann Transl Med. 2021;9(5):427. DOI: https://doi.org/10.21037/atm-20-3053

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Published

2025-02-28

How to Cite

Masood, S. O., Supriya, G., Aswini, U., Soheb, S. M., Reddy, V. A., Rafi, M. M., & Gurukul, T. V. (2025). A rare complication of tuberculosis: chronic empyema thoracis with bronchopleural fistula - a case report. International Journal of Research in Medical Sciences, 13(3), 1292–1294. https://doi.org/10.18203/2320-6012.ijrms20250702

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Section

Case Reports