Pneumatocele formation in adult pulmonary tuberculosis during antituberculous chemotherapy: a case report
© licensee BioMed Central Ltd. 2009
Received: 5 December 2008
Accepted: 19 June 2009
Published: 9 September 2009
Pulmonary pneumatoceles are thin-walled, air-filled cysts that develop within the lung. Most often, they occur as a sequela to acute pneumonia, commonly caused by Staphylococcus aureus, and are found more frequently in infants and young children. Adult tuberculous pulmonary pneumatoceles are seldom reported.
We reported a case of pulmonary tuberculosis with pneumatocele formation after antituberculous treatment. A 41-year-old man presented with fever and productive cough for 3 weeks. Chest X ray revealed cavitary lesions in bilateral upper lobes of the lung. Acid-fast rods were found in sputum and the cultures subsequently yielded Mycobacterium tuberculosis. After antituberculous treatment, obvious pneumatocele formation was noted in the right upper lobe.
The formation of pneumatoceles in adult pulmonary tuberculosis can occur before, during or after antituberculous treatment, and the development of complications of pneumatoceles was variable.
Pulmonary pneumatoceles are thin-walled, air-filled cysts that develop within the lung. Most often, they occur as a sequela to acute pneumonia, commonly caused by Staphylococcus aureus and are found more frequently in infants and young children. Adult tuberculous pulmonary pneumatoceles are seldom reported. In this article, we demonstrated the formation of pneumatoceles during antituberculous chemotherapy in a 41-year-old male with pulmonary tuberculosis.
Pulmonary pneumatoceles are air collections in the interstitium of the lung. Mostly, they occur as a sequela to acute bacterial pneumonia, reported as Staphylococcus aureus, Streptococcus pneumoniae, Proteus mirabilis, Escherichia coli, or Acinetobacter calcoaceticus. Noninfectious etiologies include hydrocarbon ingestion, trauma, and secondary to positive pressure ventilation. Pneumatocele formation in adult pulmonary tuberculosis had been seldom reported [6, 7]. In the report by Duttaroy et al. , tuberculous pulmonary pneumatocele communicating extrathoracically was recognized initially and the patient showed a remarkable clinical and radiological improvement after 8 weeks of antituberculous treatment. In the report by Long et al. , pneumatocele formation was noted following fully treated tuberculosis. In our patient, the pneumatoceles developed during antituberculous treatment without complication and our Medline research had not allowed us to identify any such cases in adult patients.
Therefore, the formation of pneumatocele in adult pulmonary tuberculosis can occur before, during or after antituberculous treatment and the development of complications of pneumatoceles was variable.
A fully informed written consent was obtained from the patient family for the publication of this case and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
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