Empyema Necessitans due to Interruption of Antituberculosis Treatment

Empyema necessitans is a rare presentation of tuberculous infection, commonly encountered in immunocompromised patients. The diagnosis can be challenging due to the paucibacillary nature of the condition and nonspecific symptoms. Identifying the organism in culture is the gold standard method of dia...

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Main Authors: H. N. Benaragama, J. Pushpakumara, Kamani P. Wanigasuriya
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2019/4810354
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author H. N. Benaragama
J. Pushpakumara
Kamani P. Wanigasuriya
author_facet H. N. Benaragama
J. Pushpakumara
Kamani P. Wanigasuriya
author_sort H. N. Benaragama
collection DOAJ
description Empyema necessitans is a rare presentation of tuberculous infection, commonly encountered in immunocompromised patients. The diagnosis can be challenging due to the paucibacillary nature of the condition and nonspecific symptoms. Identifying the organism in culture is the gold standard method of diagnosis. We describe a patient with chronic kidney disease, who developed empyema necessitans due to interruption of antituberculous therapy. Initially, he was started on antituberculous therapy based on a clinical diagnosis of smear-negative pulmonary tuberculous infection; this resulted in Stevens–Johnson syndrome needing a long course of steroid therapy. He later presented with a painful chest lump and was diagnosed as empyema necessitans. Finding the etiology for this rare presentation lead to a diagnostic dilemma, finally confirming the TB infection from the culture. This case highlights the importance of being aware of unusual complications of tuberculous infection in immunocompromised settings.
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spelling doaj-art-ba9a1154f152437e97bcc250f86f2d752025-08-20T03:23:22ZengWileyCase Reports in Infectious Diseases2090-66252090-66332019-01-01201910.1155/2019/48103544810354Empyema Necessitans due to Interruption of Antituberculosis TreatmentH. N. Benaragama0J. Pushpakumara1Kamani P. Wanigasuriya2Colombo South Teaching Hospital-Kalubowila, Dehiwala-Mount Lavinia, Sri LankaColombo South Teaching Hospital-Kalubowila, Dehiwala-Mount Lavinia, Sri LankaColombo South Teaching Hospital-Kalubowila, Dehiwala-Mount Lavinia, Sri LankaEmpyema necessitans is a rare presentation of tuberculous infection, commonly encountered in immunocompromised patients. The diagnosis can be challenging due to the paucibacillary nature of the condition and nonspecific symptoms. Identifying the organism in culture is the gold standard method of diagnosis. We describe a patient with chronic kidney disease, who developed empyema necessitans due to interruption of antituberculous therapy. Initially, he was started on antituberculous therapy based on a clinical diagnosis of smear-negative pulmonary tuberculous infection; this resulted in Stevens–Johnson syndrome needing a long course of steroid therapy. He later presented with a painful chest lump and was diagnosed as empyema necessitans. Finding the etiology for this rare presentation lead to a diagnostic dilemma, finally confirming the TB infection from the culture. This case highlights the importance of being aware of unusual complications of tuberculous infection in immunocompromised settings.http://dx.doi.org/10.1155/2019/4810354
spellingShingle H. N. Benaragama
J. Pushpakumara
Kamani P. Wanigasuriya
Empyema Necessitans due to Interruption of Antituberculosis Treatment
Case Reports in Infectious Diseases
title Empyema Necessitans due to Interruption of Antituberculosis Treatment
title_full Empyema Necessitans due to Interruption of Antituberculosis Treatment
title_fullStr Empyema Necessitans due to Interruption of Antituberculosis Treatment
title_full_unstemmed Empyema Necessitans due to Interruption of Antituberculosis Treatment
title_short Empyema Necessitans due to Interruption of Antituberculosis Treatment
title_sort empyema necessitans due to interruption of antituberculosis treatment
url http://dx.doi.org/10.1155/2019/4810354
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AT kamanipwanigasuriya empyemanecessitansduetointerruptionofantituberculosistreatment