Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Tuberculosis-Infected Giant Bulla Treated by Percutaneous Drainage Followed by Obliteration of the Pulmonary Cavity Using Talc: Case Report

  • Heo, Jeongwon (Department of Internal Medicine, Kangwon National University Hospital) ;
  • Bak, So Hyeon (Department of Radiology, Kangwon National University School of Medicine) ;
  • Ryu, Se Min (Department of Thoracic and Cardiovascular Surgery, Kangwon National University School of Medicine) ;
  • Hong, Yoonki (Department of Internal Medicine, Kangwon National University Hospital)
  • Received : 2020.08.11
  • Accepted : 2020.10.26
  • Published : 2021.10.05
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Abstract

Tuberculosis (TB)-infected giant bullae are rare. A 55-year-old man was referred when an infected bulla did not respond to empirical treatment. Computed tomography showed a giant bulla in the right upper lobe with an air-fluid level and surrounding infiltrate. Sputum culture, acid-fast bacilli (AFB) stain, and polymerase chain reaction (PCR) for TB were negative. Percutaneous drainage of the bullous fluid was performed. AFB stain and PCR were positive in the drained fluid. The patient was given anti-TB drugs and later underwent obliteration of the pulmonary cavity using talc. To summarize, we report a patient with a TB-infected giant bulla that was treated successfully with anti-TB drugs and obliteration of the pulmonary cavity using talc.

Keywords

Acknowledgement

This study was supported by 2018 Research Grant from Kangwon National University.

References

  1. Sharma N, Justaniah AM, Kanne JP, Gurney JW, Mohammed TL. Vanishing lung syndrome (giant bullous emphysema): CT findings in 7 patients and a literature review. J Thorac Imaging 2009;24:227-30. https://doi.org/10.1097/RTI.0b013e31819b9f2a
  2. Palla A, Desideri M, Rossi G, et al. Elective surgery for giant bullous emphysema: a 5-year clinical and functional follow-up. Chest 2005;128:2043-50. https://doi.org/10.1378/chest.128.4.2043
  3. Stern EJ, Webb WR, Weinacker A, Muller NL. Idiopathic giant bullous emphysema (vanishing lung syndrome): imaging findings in nine patients. AJR Am J Roentgenol 1994;162:279-82. https://doi.org/10.2214/ajr.162.2.8310909
  4. Chandra D, Soubra SH, Musher DM. A 57-year-old man with a fluid-containing lung cavity: infection of an emphysematous bulla with methicillin-resistant Staphylococcus aureus. Chest 2006;130:1942-6. https://doi.org/10.1378/chest.130.6.1942
  5. Kayawake H, Chen F, Date H. Surgical resection of a giant emphysematous bulla occupying the entire hemithorax. Eur J Cardiothorac Surg 2013;43:e136-8. https://doi.org/10.1093/ejcts/ezs280
  6. Johnson MK, Smith RP, Morrison D, Laszlo G, White RJ. Large lung bullae in marijuana smokers. Thorax 2000;55:340-2. https://doi.org/10.1136/thorax.55.4.340
  7. Ferreiro L, Suarez-Antelo J, Valdes L. Pleural procedures in the management of malignant effusions. Ann Thorac Med 2017;12:3-10. https://doi.org/10.4103/1817-1737.197762
  8. Wali SO, Shugaeri A, Samman YS, Abdelaziz M. Percutaneous drainage of pyogenic lung abscess. Scand J Infect Dis 2002;34:673-9. https://doi.org/10.1080/00365540210147660
  9. Snider GL. Reduction pneumoplasty for giant bullous emphysema: implications for surgical treatment of nonbullous emphysema. Chest 1996;109:540-8. https://doi.org/10.1378/chest.109.2.540
  10. Brant A, Eaton T. Serious complications with talc slurry pleurodesis. Respirology 2001;6:181-5. https://doi.org/10.1046/j.1440-1843.2001.00327.x