Tuesday, October 2, 2012

Sequelae of Tuberculous Pleural Disease

Tuberculosis can have varied presentations in the chest including pleural effusions. Tuberculous pleuritis has a high incidence in immunosuppressed patients, especially those with HIV. Complications of tuberculous pleural disease include:
  • pleural thickening
  • fibrothorax - calcified and thickened pleura, loss of lung volume, adjacent rib hypertrophy, epipleural fat pads, often unilateral
  • chronic persistent pleural effusion - content of the effusion are near soft tissue density
  • empyema necessitans - decompression of an empyema through the chest wall, fistulous tract between a pleural collection and an extrathoracic fluid collection may be seen, other sites of extension include breast, esophagus, pericardium, vertebral column, retroperitoneum, flank, groin
  • bronchopleural fistula - air/fluid collections in the pleural space, pleural thickening, atelectasis and bronchiectasis in ipsilateral lung, fistulous connection may be seen

Heffner JE, Klein JS, Hampson C. Diagnostic utility and clinical application of imaging for pleural space infections. Chest 2010;137(2):467-79.
Jung-Ah C, Hong KT, Oh YW, et al. CT manifestations of late sequelae in patients with tuberculous pleuritis. AJR Am J Roentgenol 2001;176(2)441-5.

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