View larger version (37K):
[in this window]
[in a new window]
|
A 73-year-old woman receiving chemotherapy for advanced breast cancer was referred for treatment of a nontuberculous empyema of the thoracic cavity (left side), which had not responded to treatment with tube thoracostomy (chest x-ray film, Panel A) and antibiotics selected on the basis of a culture of Staphylococcus aureus from pleural fluid (computed tomographic [CT] study, Panel B). The patient had undergone an ipsilateral thoracoplasty and Lucite-ball plombage for treatment of tuberculosis 50 years earlier. We proceeded with surgical evacuation of the empyema cavity. During the surgery, we noted that the disease had spared the plombage cavity, which we therefore left undisturbed. The patient made an uncomplicated recovery. No evidence of recurrence was seen on a chest x-ray film (Panel C) or on CT 5 months after surgery. Plombage is a surgical procedure previously used in the treatment of tuberculosis. Because of its high complication rate, it was abandoned after the development of effective antituberculosis drugs. In patients who have had plombage, it is important to avoid entering the plombage cavity during pleural interventions, as in this case, so that infection is not introduced into this otherwise sterile space.
|
Previous
