DOI: 10.36347/sjmcr.2023.v11i05.008

Pages: 782-785

Introduction: Tuberculosis is still a public health problem in Morocco. Tuberculous pyopneumothorax is a rare but serious complication secondary to the rupture of a tuberculous cavern in the pleural cavity. It is a well-known clinical form occurring mainly in extensive forms of tuberculosis and in frail patients. In our context, it poses a management problem. We report the case of a young man, chronic smoker, who presented with dyspnea and productive cough revealing a tuberculous pyopneumothorax. Case Report: The patient was a 28 year old male, chronic smoker with 10 PA always active, without any particular pathological history, who had been presenting for 2 months with a productive cough bringing back yellowish sputum with Sadoul stage III dyspnea, and progressive chest pain, all evolving in a context of altered general condition and feverish feeling. The clinical examination found a conscious patient, polypneic at 26 cpm, febrile at 38C°, hemodynamically stable, with objective pleuro pulmonary examination of a left aerial pleural effusion syndrome. A chest X-ray was requested in first intention, objectifying an opacity occupying the internal 2/3 of the left pulmonary hemichamp, not very dense, heterogeneous, seat of some cartées within it in connection with bronchograms with a clear external and internal limit drowned in the mediastinum, a left pneumothorax of great abundance made of an axilobasal parenchymatous hyperclarity without vascular framework with enlargement of the EICs and refoulement of the elements of the mediastinum towards the counter lateral side, and a filling of the left costo diaphragmatic cul de sac. A complementary thoracic CT scan noted a left hydropneumothorax of great abundance associated with pneumonic foci complicated by abscesses and multiple branching micronodules of the right upper lobe and middle lobe suggestive of a tuberculous origin. A drainage of the pyo-pneumothorax was performed with a bacteriological, cytological and ..........