Tuberculous empyema

As outlined pleural empyema infected with TB and that tuberculous empyema. Often because the diagnosis, treatment and the long-delayed formation of a more chronic empyema. Pleural tuberculosis causes violations of ways : by blood or lymphatic circulation causing infections, pulmonary tuberculosis direct violation of pleural lesions, or lesions rupture of tuberculosis directly into the chest, while the gas into the chest, and formed pyopneumothorax. even bronchopleural fistula. Empyema is artificial pneumothorax or surgical treatment of tuberculosis complications. Bone tuberculosis or tuberculosis chest wall may also penetrated the chest. Pathological changes of pleural tuberculosis infection early, acute inflammation, congestion, exudative, and form nodules scattered tuberculosis, Pleural effusion as serous containing leukocyte protein and fiber, take a longer period of time gradually becomes chronic tuberculous empyema. Fiberboard thick, hard, and often calcification. Fiberboard contraction so that intercostal space narrowing, ribs deformation was triangular cross-section, intercostal muscle atrophy, spinal convex to the healthy side. Empyema can be restricted or wholly empyema. Empyema sometimes to the intercostal rupture, or even violating the ribs, cold abscess formation or break up the skin form of skin sinus, discharging more than long-term. Diagnostic X-ray and chronic empyema basically the same, with the contralateral lung lesions of tuberculosis easier diagnosis, ipsilateral lung TB lesions are often covered up by effusion, it is difficult to determine the nature. Thoracentesis out more rarefied Pott, Pott may contain stem Cool-like substance. Be diagnosed in Pott found tuberculosis, but in clinical testing, it is very difficult to check TB. Therefore, when Pott lymphocytes, or ordinary bacterial culture negative, it should consider tuberculous empyema, TB patients with empyema, should first consider tuberculous empyema diagnosis. X-ray shows the size Vomica, at the same time show whether pulmonary tuberculosis and diseases, CT better understanding of the disease and Vomica minor changes. Clinical manifestations of tuberculous empyema the clinical manifestations vary considerably, the majority of the slow onset, fatigue, fever as the main symptoms, Secondly not night sweating, chest tightness, coughing, the early pleural empyema absorption is quite strong, and the more obvious symptoms of poisoning. If empyema more could happen short breath, difficulty in breathing and other symptoms. When bronchopleural fistula, it will be irritating cough, cough and sputum the position. Contralateral berth when cough and sputum increase. If bronchopleural fistula caused Disseminated tuberculosis, poisoning symptoms will be very clear that the severity of illness. After infection, fever, leukocytosis, with symptoms similar to acute empyema. Treatment of tuberculous empyema is the main treatment antituberculosis treatment often requires the combined application of isoniazid, rifampicin, streptomycin and ethambutol the three drugs. Early tuberculosis sex Leung, empyema small, active and effective anti-tuberculosis treatment, nutrition, proper rest, may improve absorption. If a large number of effusion, pleural puncture trip was to promote acceptance, it must pay attention to preventing secondary infection. In the event beyond the control of the drug secondary infection should be avoided before the close thoracic drainage, TB because the pathological changes in lung tissue and can not expand, thoracic drainage after Vomica not eliminated, but will also increase the chance of infection. If tuberculous empyema with bronchopleural fistula or serious infection, to be at full positive drainage at the same time strengthen the antibiotic treatment, otherwise difficult to control disease, but also may increase lung metastasis, to be considered in stable condition after surgery. Tuberculous empyema of the major thoracic surgery angioplasty and pleural pneumonectomy. not only in lung lesions with no air support endometrial tuberculosis caused by bronchial stenosis circumstances they can be adopted stripping pleural fibreboard detachment surgery, lung not expand, Vomica not kill, or swelling of lung after lung lesion formation empty deterioration, resulting in surgery failed. Surgery should antituberculous therapy for more than 3 months, tuberculosis under control, stability after the lesion.