title: Retrospective case series analysing the clinical data and treatment options of patients with a tubercular abscess of the chest wall.
abstract: The tubercular abscess of the chest wall remains one of the differential diagnoses of a chest wall tumour, and the management strategy is controversial. We reviewed the medical records of 22 patients treated at our institution. Two patients were managed by antitubercular medications alone; eight patients were managed by medication and open drainage. Five patients underwent open drainage with subsequent radical surgery at a constant interval of time, and the mean duration between open drainage and radical surgery was 9.8 weeks (range, 3-12). Seven patients underwent radical surgery without prior open drainage. Five patients required rib resections, and curettage of infected pleural peel was necessary in 5 patients. Antitubercular drugs were administered basically for more than 6 months regardless of surgical management, including for more than 1 month prior to radical surgery. Postoperative empyema was seen in 1 patient after radical surgery. The mean follow-up duration was 32.8 months (range, 3-100), and there was no recurrence. Complete resection of the tubercular abscess with sufficient antitubercular therapy resulted in a satisfactory outcome. Antitubercular therapy with or without open drainage can be a viable choice.
authors.affiliation: Department of Thoracic Surgery, Nishi-Kobe Medical Center, Nishi-ku, Kobe, Japan. satonat@nmc-kobe.org
authors.forename: Satona
authors.initials: S
authors.lastname: Tanaka
authors.forename: Minoru
authors.initials: M
authors.lastname: Aoki
authors.forename: Takao
authors.initials: T
authors.lastname: Nakanishi
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Otake
authors.forename: Masataka
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Toshiyasu
authors.initials: T
authors.lastname: Sakurai
authors.forename: Kimihide
authors.initials: K
authors.lastname: Tada
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ikeda
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001706:Biopsy; D004269:DNA, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D013896:Thoracic Diseases / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D019616:Thoracic Surgical Procedures / Q000379:methods*; D035441:Thoracic Wall; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D004269:DNA, Bacterial