Presentation
Old case of pulmonary Koch's, treatment defaulter. Now presenting with cough and breathing difficulty
Patient Data
Plain CT of chest reveals a thick rind of pleura in the left hemithorax, with thick and irregular calcification of both visceral and parietal pleura encasing a small amount of hypodense loculated pleural collection.
Few calcified mediastinal lymphnodes are also seen. Small parenchymal granuloma calcifications and fibrosis are seen.
Volume loss in the left hemithorax. There is mild thickening of ribs seen on the left side with a rather crowded appearance due to ipsilateral lung volume loss.
Case Discussion
Tuberculous empyema is a chronic, active infection of the pleural space characterized by thick rind of pleura with thick and irregular calcification of both parietal and visceral pleura usually surrounding a loculated pleural fluid which contains a large number of tubercle bacilli.