Dantis Klein, Dey Chandan Kumar, Phuli Roopali, Ramavath Vinod Kumar
Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Bathinda, India.
Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Raipur, India.
Tanaffos. 2024 Mar;23(3):304-307.
Multi-drug-resistant tuberculosis (MDR-TB) has become a significant health problem worldwide. As per the Global Tuberculosis Report 2021, chemotherapy has only benefitted 59% of individuals. As many patients do not benefit from radical surgery due to their poor pulmonary reserve, bacterial overload, and prognosis, collapse therapy has an essential role in improving the effectiveness of complex anti-tubercular therapy.
A 35-year-old male with a low body mass index and persistent air leak on an intercostal tube not responding to medical management underwent thoracoscopic decortication. He was diagnosed with multi-drug-resistant tuberculosis (MDR-TB) according to the pleural specimen. Postoperatively, the lung did not seem to expand due to the extensive disease, and the air leak persisted. Hence, he received a short-term MDR-TB regimen and underwent open window thoracostomy followed by limited thoracoplasty for postoperative persistent infected pleural space.
Though pleural MDR-TB is a rare presentation, managing the infected pleural space is challenging as patients tend to have significant morbidity due to various factors.
耐多药结核病（MDR-TB）已成为全球重大的健康问题。根据《2021年全球结核病报告》，化疗仅使59%的患者受益。由于许多患者肺储备功能差、细菌负荷高和预后不佳，无法从根治性手术中获益，萎陷疗法在提高复杂抗结核治疗的有效性方面具有重要作用。
一名35岁男性，体重指数低，肋间引流管持续漏气，药物治疗无效，接受了胸腔镜剥脱术。根据胸膜标本，他被诊断为耐多药结核病（MDR-TB）。术后，由于病情广泛，肺部似乎未扩张，漏气持续存在。因此，他接受了短期耐多药结核病治疗方案，并接受了开窗胸廓造口术，随后进行了有限胸廓成形术，以处理术后持续存在的感染性胸膜腔。
虽然胸膜耐多药结核病是一种罕见的表现，但由于各种因素，患者往往有明显的发病率，因此处理感染性胸膜腔具有挑战性。
