Rapidly Growing Mycobacterium tuberculosis in the Form of Empyema Necessitans: A Case Report

We present a case of rapidly growing disseminated Mycobacterium tuberculosis (MTB) that presented as an empyema necessitans (EN) in a 65-year-old woman with a single right lung transplant admitted for progressive dyspnea. While hospitalized, she had daily fevers and was found to have a right-sided chest wall abscess and pleural effusion. Acid-fast bacilli cultures from the abscess and pleural fluid grew MTB within 4 and 6 days, respectively. Blood cultures later grew MTB as well. Upon initiation of rifampin, isoniazid, pyrazinamide, and ethambutol, she developed hemorrhagic pancreatitis and distributive shock secondary to antituberculosis medications and disseminated MTB. Noteworthy features of this case include the rapid rate of MTB culture growth in less than a week, the development of a likely donor-derived MTB EN, and the clinical challenges of MTB screening and MTB infection management in a solid organ transplant recipient.

Staphylococcus aureus costochondritis and chest wall abscess in a COVID-19 patient treated with tocilizumab

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, causing a global health threat. Up to 15% of the confirmed cases develop severe disease, requiring hospitalization or intensive care unit (ICU) admission. Tocilizumab, an IL-6 receptor antagonist, is a promising treatment of severe pneumonia with acute respiratory distress syndrome (ARDS) or cytokine release syndrome (CRS) in the course of COVID-19. We report a suppurative costochondritis and chest wall abscess in a severe COVID-19 patient treated with tocilizumab.

Incidental Finding of Tuberculosis During Evaluation for Delayed Wound Healing

ABSTRACT Cutaneous tuberculosis (TB) is an uncommon form of extrapulmonary TB that can be difficult to diagnose. The following case is about a 14-year-old female who was experiencing delayed wound healing after an incision and drainage of a chest wall abscess. A computed tomography scan of her chest obtained 2 months after the procedure revealed pulmonary findings consistent with TB. An acid-fast bacilli culture was obtained from the wound after the computed tomography scan was performed and was positive for Mycobacterium tuberculosis 8 weeks later. Although TB is relatively uncommon in the United States, it is more prevalent in the Republic of Korea where the patient lives and was evaluated. This case serves to illustrate the long history of challenges the military medical community has faced with TB and to remind providers to be cognizant about local common diseases when serving overseas and include these diagnoses in their differentials.

Pleuropneumonia with chest wall abscess due to salmonella enteric in immunocompetent patient: a case report

Introduction: Pleuropulmonary with bony and cutaneous involvement of salmonella infection is a very rare condition and no case was ever reported in Lebanon. Case presentation: We report a case of 39-year-old immunocompetent man, with no past medical history, presented with a right bulging chest wall mass. The chest radiographs revealed pleural effusion and presence of a hypodense central necrosis at right lower lung field. Salmonella was identified from the cultures of fine needle aspiration (FNA) form the mass. After treating salmonella with adequate antibiotics, the patient was improved. Discussion: salmonella infection is a common bacterial disease that affects the intestinal tract. Infection may spread beyond the intestine causing many complications like in our reported case. Conclusion: we should suspect salmonellosis in any patient presenting with gastrointestinal symptoms followed by pleuropneumonia with chest wall infection.