Tuberculosis-associated secondary pneumothorax: a retrospective study of 53 patients.
BACKGROUND
Pneumothorax is a well known complication of pulmonary tuberculosis (TB), particularly in patients with advanced TB.


METHODS
At our national TB-referral hospital, we compared the medical records of 53 TB patients with pneumothorax and 106 TB patients without pneumothorax, seen in 2003 to 2008. We analyzed data on demographics; TB type (smear-positive, smear-negative, extrapulmonary); patient type (new patient, relapse, treatment default, treatment failure); clinical and radiological manifestations; surgeries; and outcomes.


RESULTS
Of the 53 pneumothorax patients, 34 (64%) were male. The pneumothorax group's mean age was 34 y (range 14-76 y). Thirty-six (68%) of the pneumothorax patients were new TB cases (ie, TB undiagnosed before they presented with pneumothorax). Pneumothorax was not significantly associated with sex, smoking, or drug use. Pneumothorax was significantly more common in patients < 30 years old (P < .001). In terms of radiological manifestations, 20 pneumothorax patients (38%) had cavitary lesions, and pulmonary infiltration and effusion were present in 19 (36%) and 17 (32%) patients, respectively. Cavitary lesion was significantly more common among the pneumothorax patients (P = .006). Overall, 47 (89%) of the pneumothorax patients were relieved with chest-tube insertion; the other pneumothorax patients were only observed.


CONCLUSIONS
In patients < 30 years old or with cavitary lesions, worsening of the patient's respiratory condition should prompt consideration of pneumothorax.
National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran. dr_shamaei@yahoo.com
Masoud
M
Shamaei
Payam
P
Tabarsi
Saviz
S
Pojhan
Leila
L
Ghorbani
Parvaneh
P
Baghaei
Majid
M
Marjani
Mohammad Reza
MR
Masjedi
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006872:Hydropneumothorax / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D007492:Iran; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D011030:Pneumothorax / Q000175:diagnosis* / Q000382:microbiology* / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D055815:Young Adult