Clinical analysis of mycobacteriosis patients with pneumothorax
Takahashi, N.; Hoshi, E.; Kagiyama, N.; Yanagisawa, T.; Sugita, Y.
Kekkaku 87(10): 649-653
2012
ISSN/ISBN: 0022-9776 PMID: 23214121 Document Number: 657796
Secondary pneumothorax caused by mycobacteriosis is rare. The frequency of incidence of pneumothorax in tuberculosis patients is reported to be only 1.5%, and that in nontuberculous mycobacteriosis patients may be very low. It is important to detect mycobacteriosis at an earlier stage in patients hospitalized for pneumothorax, in general wards so that nosocomial infections such as tuberculosis can be prevented. Chart review of mycobacteriosis patients with secondary pneumothorax admitted to the isolation ward, and that of the mycobacteriosis patients with pneumothorax admitted in the general wards of our hospital. We reviewed records of 555 mycobacteriosis patients admitted to the isolation ward of our hospital from January 2006 to December 2008. We analyzed the reasons for admission and cause, treatment, and outcome of pneumothorax. Of the 555 mycobacteriosis patients, 11 (2.0%) had complications of pneumothorax. Among these 11 patients, 9 had tuberculosis, and 2 had nontuberculous mycobacteriosis. Of the 11, 5 were discharged, but 6 (54.5%) died during hospitalization, while among the remaining 544 mycobacteriosis patients without pneumothorax, 49 (9%) died during hospitalization. The hospital death rate of mycobacteriosis patients with pneumothorax was significantly higher than that of mycobacteriosis patients without pneumothorax (p < 0.0001). Among the 9 tuberculosis patients, 4 in whom pneumothorax was caused by rupturing of bullae showed improvement except one patient, but 5 in whom pneumothorax was caused by tuberculosis died. Excluding the 555 patients admitted to the isolation ward, 388 pneumothorax patients were admitted to the general ward during the same period, among which 3 (0.8%) had mycobacteriosis. Tuberculosis-induced pneumothorax has a poor prognosis because the occurrence of tuberculosis impairs the mechanism of recovery from pneumothorax.