Tube thoracostomy-related necrotizing fasciitis: a case report.
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.
Hsu
Shun-Pin
SP
Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Wang
Hong-Chung
HC
Huang
I-T
IT
Chu
Kuo-An
KA
Chang
Huang-Chou
HC
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*