title: Tube thoracostomy-related necrotizing fasciitis: a case report.
abstract: Spontaneous pneumothorax is a serious complication of pulmonary tuberculosis that requires immediate treatment. Necrotizing fasciitis is a serious, rapidly progressive infection of the subcutaneous tissue and fascia, most related to trauma or surgery. Here, we report a case of pulmonary tuberculosis with spontaneous pneumothorax. A standard procedure of tube thoracostomy was performed for lung re-expansion. Two days after the tube was removed, necrotizing fasciitis developed from the puncture site. Computed tomography of the chest showed focal thickness with gas formation and loss of the fat plane over the chest wall, which is compatible with the diagnosis of necrotizing fasciitis. Aggressive treatment was given, including emergency fasciectomy and adequate systemic antibiotic and antituberculous treatment. The necrotizing fasciitis was successfully treated. The patient was discharged and sent home with maintenance antituberculous therapy.
authors.affiliation: Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Shun-Pin
authors.initials: SP
authors.lastname: Hsu
authors.forename: Hong-Chung
authors.initials: HC
authors.lastname: Wang
authors.forename: I-T
authors.initials: IT
authors.lastname: Huang
authors.forename: Kuo-An
authors.initials: KA
authors.lastname: Chu
authors.forename: Huang-Chou
authors.initials: HC
authors.lastname: Chang
mesh_terms: D019115:Fasciitis, Necrotizing / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000601:surgery*; D013907:Thoracostomy / Q000009:adverse effects*; D014397:Tuberculosis, Pulmonary / Q000150:complications*