Successful nonsurgical treatment of tuberculous empyema in an irreducible pleural space.
A 78-year-old woman with empyema due to Mycobacterium tuberculosis in a chronic pleural space was successfully treated with a 24-month course of oral isoniazid, rifampin, ethambutol, and serial space-emptying thoracocenteses. Besides dramatic clinical improvement, follow-up pleural fluid analyses demonstrated gradual replacement of the empyema with a sterile pleural exudate, which has persisted 24 months after cessation of therapy. This case demonstrates a therapeutic program that was an effective alternative to decortication or thoracoplasty for tuberculous empyema in an irreducible pleural space.
D000284:Administration, Oral; D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage*; D004654:Empyema, Tuberculous / Q000188:drug therapy / Q000628:therapy*; D004977:Ethambutol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage; D011677:Punctures; D012293:Rifampin / Q000008:administration & dosage; D014396:Tuberculosis, Pleural / Q000628:therapy*
D000995:Antitubercular Agents; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin