Spontan pnömotoraksla prezente olan iki tüberküloz olgusu
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Tarih
2011
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Sekonder spontan pnömotoraksın klinik manifestasyonları akciğer tüberkülozu ve nonspesifik diğer akciğer hastalıkları olan bireylerde saptanmıştır. Pnömotoraks pulmoner tüberkülozun önemli ve tehlikeli bir komplikasyonudur. Biz de benzer klinik prezentasyonları olan ve pulmoner tüberküloza sekonder gelişen spontan pnömotoraks saptadığımız iki olguyu, bu nedenle sunmayı uygun bulduk. Olgular: Olgu 1: Otuz altı yaşında bayan hasta ani başlayan nefes darlığı şikayetiyle acil servisimize başvurdu. Hastanın çekilen akciğer grafisinde; sağ total pnömotoraks saptanması üzerine tüp torakostomi uygulandı. Takiplerinde 3. gün ampiyematöz plevral mayi drenajı izlenmesi üzerine çalışılan plevral sıvı ve balgamda ARB pozitifliği saptandı. Hastaya tüberküloz plörezi ve akciğer tüberkülozu tanılarıyla 4’lü antitüberküloz tedavi başlandı. Takibinde akciğeri ekspanse olan ve plevral mayi drenajı kesilen hastanın 42. günde dreni alındı ve antitüberküloz tedavisine ayaktan devam edilmek üzere taburcu edildi. Olgu 2: Kırk sekiz yaşında erkek hasta ani başlayan nefes darlığı, öksürük şikayetiyle acil servisimize başvurdu. Hastanın çekilen akciğer grafisinde; sol pnömotoraks saptanması üzerine tüp torakostomi uygulandı. İşlem sonrası çekilen kontrol grafi’de; sol akciğerin ekspanse olduğu görüldü. Fakat sol parakardiyak alanda nonhomojen opasite izlenmesi nedeniyle tüberküloz düşünülerek gönderilen balgam ARB’nin () saptanması üzerine 4’lü antitüberküloz tedavi başlandı. Kliniği düzelen ve takibinde dreni alınan hasta antitüberküloz tedavisine ayaktan devam edilmek üzere 8. gün taburcu edildi. Sonuç: Pulmoner tüberküloz, klinik olarak pnömotoraks şeklinde prezente olduğu zaman hayatı tehdit eden ve acil müdahale gerektiren bir akciğer hastalığı olarak göz önünde bulundurulmalıdır.
Purpose: Clinical manifestations of secondary spontaneous pneumothorax were detected in patients with lung tuberculosis and other non-specific lung diseases. Pneumothorax is an important and dangerous complication of pulmonary tuberculosis. Thus, we report two pulmonary tuberculosis cases presented with spontaneous pneumothorax. Cases:Case 1: A 36-years-old female patient admitted to our emergency department with a complaint of sudden onset shortness of breath. Chest graph displayed a right total pneumothorax and tube thoracostomy was performed. She had empyematous pleural fluid drainage on 3rd day and positivity for ARB was detected in pleural fluid and sputum. Four-drug anti-tuberculosis therapy was started with the diagnoses of tuberculosis pleurisy and lung tuberculosis. The tube was removed after her lung had expanded and pleural fluid drainage had ceased on 42nd day, and discharged with the continuation of therapy at home. Case 2: A 48 years old male patient admitted with complaints including sudden onset shortness of breath and cough. Chest graph showed left pneumothorax and tube thoracostomy was performed. Chest graph of post-intervention showed that the lung was completely expanded but also there was a left para-cardiac infiltration. It was thought that the infiltration may have been of tuberculosis and studied sputum ARB was positive and a four-drug anti-tuberculosis therapy was started. The patient got well clinically and the tube was removed on 8th day and he was discharged with the continuation of therapy at home. Conclusion: Pulmonary tuberculosis should be kept in mind that it may be life threatening and need emergent intervention when presented with pneumothorax.
Purpose: Clinical manifestations of secondary spontaneous pneumothorax were detected in patients with lung tuberculosis and other non-specific lung diseases. Pneumothorax is an important and dangerous complication of pulmonary tuberculosis. Thus, we report two pulmonary tuberculosis cases presented with spontaneous pneumothorax. Cases:Case 1: A 36-years-old female patient admitted to our emergency department with a complaint of sudden onset shortness of breath. Chest graph displayed a right total pneumothorax and tube thoracostomy was performed. She had empyematous pleural fluid drainage on 3rd day and positivity for ARB was detected in pleural fluid and sputum. Four-drug anti-tuberculosis therapy was started with the diagnoses of tuberculosis pleurisy and lung tuberculosis. The tube was removed after her lung had expanded and pleural fluid drainage had ceased on 42nd day, and discharged with the continuation of therapy at home. Case 2: A 48 years old male patient admitted with complaints including sudden onset shortness of breath and cough. Chest graph showed left pneumothorax and tube thoracostomy was performed. Chest graph of post-intervention showed that the lung was completely expanded but also there was a left para-cardiac infiltration. It was thought that the infiltration may have been of tuberculosis and studied sputum ARB was positive and a four-drug anti-tuberculosis therapy was started. The patient got well clinically and the tube was removed on 8th day and he was discharged with the continuation of therapy at home. Conclusion: Pulmonary tuberculosis should be kept in mind that it may be life threatening and need emergent intervention when presented with pneumothorax.
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