Kniehl E, Wenzler A, Joggerst B, Schorn T, Barcsay E
Abteilung für Mikrobiologie und Krankenhaushygiene, Klinikum Karlsruhe, Federal Republic of Germany.
Wien Klin Wochenschr. 1998 Oct 30;110(20):725-8.
In the 1940s, oleothorax (paraffin oil instillation) was widely used to treat patients with apical tuberculosis. The oil plombage should have been removed after a few years; however, since oleothoraces were usually asymptomatic, removal was uncommon. These in the meantime elderly patients are at risk of late complications, such as rupture of the oleothorax and aspiration of oil. We report the case of a 69-year-old man with a spontaneous rupture of an oleothorax leading to oil aspiration, lipid pneumonia and culture-proven disseminated tuberculosis with fatal outcome. Unexpected positive PCR for M. tuberculosis-DNA in tracheal secretions was one of the leading signs in this case. Thus oil plombage in patients with oleothorax may be "time bombs". Primary physicians should be aware of this life-threatening complication.
在20世纪40年代，油胸（石蜡油注入）被广泛用于治疗肺尖结核患者。几年后就应该取出油填充材料；然而，由于油胸通常没有症状，取出的情况并不常见。与此同时，这些老年患者有发生晚期并发症的风险，如油胸破裂和油吸入。我们报告一例69岁男性患者，其油胸自发破裂导致油吸入、脂质性肺炎以及经培养证实的播散性肺结核，最终死亡。气管分泌物中结核分枝杆菌DNA的意外阳性PCR结果是该病例的主要征象之一。因此，油胸患者体内的油填充材料可能是“定时炸弹”。基层医生应意识到这种危及生命的并发症。
