Rupture of therapeutic oleothorax leading to paraffin oil aspiration and dissemination of tuberculosis--a fatal late complication of tuberculosis therapy in the 1940s.

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.