Management of primary chest wall tuberculosis

• Published in: Scandinavian journal of thoracic and cardiovascular surgery Vol. 29; no. 3; p. 119
• Main Authors: Hsu, H S, Wang, L S, Wu, Y C, Fahn, H J, Huang, M H
• Format: Journal Article
• Language: English
• Published: Sweden 1995
• Subjects: Abscess - diagnosis; Adult; Antibiotics, Antitubercular - therapeutic use; Antitubercular Agents - administration & dosage; Antitubercular Agents - therapeutic use; Combined Modality Therapy; Debridement; Diagnosis, Differential; Ethambutol - therapeutic use; Female; Humans; Isoniazid - therapeutic use; Male; Middle Aged; Pyrazinamide - therapeutic use; Retrospective Studies; Rifampin - therapeutic use; Suppuration; Thoracic Diseases - diagnosis; Thoracic Diseases - microbiology; Thoracic Diseases - pathology; Thoracic Diseases - therapy; Thoracic Neoplasms - diagnosis; Treatment Outcome; Tuberculosis - diagnosis; Tuberculosis - pathology; Tuberculosis - therapy
• ISSN: 0036-5580
• DOI: 10.3109/14017439509107217

Primary tuberculosis of the chest wall is rare and its clinical presentation may resemble pyogenic abscess or tumour. The diagnosis is difficult, since smears or cultures of aspirate frequently fail to show tubercle bacilli. Seven cases of primary chest-wall tuberculosis treated between 1973 and 1992 are described. All presented with a progressively enlarging mass. The diagnosis was based on bacteriologic and histologic findings, but definitive diagnosis was obtained before treatment in only two cases. Satisfactory results were obtained with surgical debridement and specific chemotherapy in six cases and with chemotherapy alone in one case. From this limited experience, we suggest that primary chest-wall tuberculosis should initially be treated with a combination regimen of antituberculous chemotherapy, which should take more than 9 months. If the lesion progressively enlarges or secondary infection occurs, however, adequate surgical debridement is also required.