Tuberculous Abscess
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A previously healthy 18-year-old man was admitted to the hospital with a 3-month history of coughing, expectoration of reddish sputum, weight loss and fever; a small region of swelling had developed on his anterior chest wall in the preceding week. A computed tomographic (CT) scan of the chest obtained on admission showed a collar-button abscess, consisting of an abscess in a lymph node in the left mediastinum (Panel A, red arrow) connected to a subcutaneous abscess in the anterior chest wall (Panel A, blue arrow). CT also revealed an extensive parenchymal abnormality in the left upper lobe. A sputum smear showed acid-fast bacteria, and a culture grew pansusceptible Mycobacterium tuberculosis. Tests for HIV were negative. The patient received 8 weeks of standard antituberculous treatment, but the infection progressed, with increased swelling, erythema, and fluctuation of the subcutaneous abscess (Panels B and C). The abscess was subsequently treated with open drainage...

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Dr. M●. S●●●●●l I●●●m S●●●n
Dr. M●. S●●●●●l I●●●m S●●●n Internal Medicine
Abscess drainage plus category 2 antitubercular chemotherapy must needed for this patient.
Jul 13, 2017Like