Recurrent pneumothorax: A rare complication of miliary tuberculosis

Abstract

Context:Recurrent pneumothorax is common in cavitory pulmonary tuberculosis, but it is extremely rare in miliary tuberculosis.Case Report:A 25 year old female patient presented to us with the complains of shortness of breath since 3 days. She was also having fever and cough since 3 months. Chest roentgenogram (PA view) on admission showed a left sided pneumothorax with miliary mottling. An intercostals tube drainage was done on the left side resulting in relief of symptoms. Two days post intercostals tube drainage chest X ray (PA view) showed complete resolution of pneumothorax, and intercostals tube was removed. Patient was discharged on antitubercular drugs. After 1 month patient again presented to us with severe breathlessness, on repeat chest X ray pneumothorax again developed on left side, urgent intercostals tube drainage was done, and patient relieved immediately. Patient was kept in the hospital for 12 days and, and was discharged after intercostals tube removal.Conclusion:If a patient of miliary tuberculosis presents with shortness of breath diagnosis of pneumothorax should be considered.

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“…Although this disease is caused by a bacterium and not a virus, the resulting x-ray picture of localised calcifications is well recognised and is termed miliary tuberculosis. 19,20 It is also possible that the risk of developing complications of Zika may reflect the genetic differences between the sufferers and the general population. But at the present stage of our knowledge there is no indication of what particular differences might be important.…”

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“…The reported frequency of occurrence of pneumothorax in tuberculosis is 1.5% 4 . Air leak and pneumothorax is a well‐known phenomenon in adult‐onset cavitary tuberculosis but is very rare in miliary tuberculosis 5 . In children, it has been reported that miliary tuberculosis may very rarely present with unilateral or bilateral pneumothorax 6 .…”

“…The recognition of pneumothorax might be delayed in these children as the clinical features may be masked by the baseline respiratory distress present in miliary tuberculosis. 5 Delayed recognition might be life-threatening. Miliary tuberculosis with spontaneous pneumothorax can be treated mostly with intercostal tube drainage.…”

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