TB Empyema
- TB was at one time a common cause of empyema.
- It was more likely than other types of empyema to result in empyema necessitans, ie bursting of the pus through the chest wall to the exterior.
- Prior to the pus actually erupting, a chest wall swelling appears and the patient will often seek medical attention at this stage.
- The situation can then be pre-empted by surgically incising the fluctuant chest wall swelling and evacuating the pus.
- Care has to be taken that large quantities of pus are not inhaled into the bronchial tree when carrying out this procedure.
- It is best done under local anaesthesia and the patient should be warned of the possibility of sudden expectoration of pus during the procedure.
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These pictures illustrate a patient who presented with empyema necessitans due to reactivated pulmonary tuberculosis.
