Pleuroscopy for Tuberculosis Pleurisy Mimicking Heart Failure with Bilateral Pleural Effusion: A Case Report

肋膜腔鏡用於結核性肋膜炎模仿心臟衰竭合併雙側肋膜積水：病例報告

李忠恕(Chung-Shu Lee) ； 鍾福財(Fu-Tsai Chung) ； 李適鴻(Shih-Hong Li) ； 王志偉(Chih-Wei Wang) ； 張志豪(Chih-Hao Chang)

《內科學誌》 28卷6期 (2017/12) Pp. 366-371

https://doi.org/10.6314/JIMT.2017.28(6).06

摘要

We herein report the case of an 85-year-old woman with tuberculosis (TB) pleurisy presenting as heart failure and bilateral pleural effusions. The patient was admitted to our hospital because of shortness of breath and bilateral pleural effusions. She received diuretics treatment, but the pleural effusions did not resolve. Chest computed tomography revealed pleural effusion with lung atelectasis. Because no definite diagnosis was made after thoracentesis, the patient underwent pleuroscopy. A biopsy of the pleural nodules was done, and the specimen was diagnosed as granulomatous inflammation, suspected Mycobacterium tuberculosis infection. The patient’s pleural effusion resolved after anti-tuberculosis treatment.

關鍵字

Medical thoracoscopy ； Pleuroscopy

並列摘要

我們在這裡報告一名85歲的結核性肋膜炎女性表現為心臟衰竭合併雙側肋膜積水的病例。病人由於喘以及雙側肋膜積水而入院。她先接受利尿劑治療，但肋膜積水無法消除。胸部電腦斷層掃描顯示肋膜積水與肺擴張不全的變化。由於胸腔穿刺檢查後無明確診斷，病患接受肋膜腔鏡檢查。肋膜切片結果診斷為肉芽腫性炎症，疑似結核感染。在接受抗結核藥物治療後，她的肋膜積水就改善了。