Mancini P, Mazzei L, Zarzana A, Biagioli D, Sposato B, Croce G F
2nd Department of Pneumology, C. Forlanini Hospital, University of Rome La Sapienza, Italy.
Eur Rev Med Pharmacol Sci. 1998 Jan-Feb;2(1):25-9.
The authors present 110 cases of patients hospitalized in the last 5 years, with long-term disabling sequelae of pulmonary tuberculosis. Twelve out of them (= 10.9%) suffered from post-tuberculous chronic empyema, with an average latency period of 44.83 years between the acute tuberculous illness and the clinical manifestation of the empyema. Nine of the patients had been treated with collapsotherapy, induced by artificial intrapleural pneumothorax, 1 with thoracoplasty, and 2 only with late and inadequate anti-mycobacterial chemotherapy. Eleven patients (91.6%) also had a cutaneous fistula (7 cases) and/or a bronchopleural fistula (4 cases). The authors show how the issue of tuberculous sequelae is a significant not only from the numerical standpoint, but also for the seriousness of the caused pathological conditions, often posing problems for differential diagnosis. Moreover, they stress how tuberculosis should never be neglected or considered last in the differential diagnosis of empyema and pyopneumothorax.
作者介绍了过去5年中住院的110例患有肺结核长期致残后遗症的患者。其中12例（=10.9%）患有结核后慢性脓胸，从急性结核疾病到脓胸临床表现的平均潜伏期为44.83年。9例患者接受了人工胸腔内气胸诱导的萎陷疗法治疗，1例接受了胸廓成形术，2例仅接受了晚期且不充分的抗分枝杆菌化疗。11例患者（91.6%）还患有皮肤瘘（7例）和/或支气管胸膜瘘（4例）。作者指出，结核后遗症问题不仅在数量上很重要，而且因其所导致的病理状况的严重性，常常给鉴别诊断带来问题。此外，他们强调在脓胸和气胸的鉴别诊断中，结核病绝不应被忽视或被排在最后考虑。
