Physical Medicine and Rehabilitation Management in Patient with Loculated Empyema, Pleural Effusion et causa Chylothorax on WSD, Gastrointestinal Tuberculosis and History of Drop-Out Pulmonary Tuberculosis: A Case Report
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Published:
Jun 28, 2023
Keywords:
Extrapulmonary TB, Gastrointestinal TB, Loculated empyema, Pulmonary rehabilitation.
Main Article Content
Abstract
Introduction: Tuberculosis (TB) is a lung disease caused by Mycobacterium tuberculosis (MTB), known for its high morbidity and mortality rate. When it infects organs outside the lungs, the condition is called extrapulmonary TB.
Case report: A 52-year-old man who came to dr. Cipto Mangunkusumo hospital with worsening abdominal pain since a month ago. During the physical examination, tenderness in the right lower quadrant of the abdomen was felt. Furthermore, blood work showed leukocytosis and thrombocytosis. An X-ray examination revealed loculated pleural effusions. A WSD was placed, and pleural fluid analysis resulted in chylus. Sputum smears were negative. An abdominal CT scan revealed irregular thickening of the caecum wall extending to part of the large intestine and multiple surrounding lymphadenopathies. The patient was diagnosed with gastrointestinal TB and received category 1 anti-TB drugs.
Conclusion: The patient also underwent pulmonary rehabilitation and had improvements at the end of the hospitalization period.
Keywords: Extrapulmonary TB, Gastrointestinal TB, Loculated empyema, Pulmonary rehabilitation.
Case report: A 52-year-old man who came to dr. Cipto Mangunkusumo hospital with worsening abdominal pain since a month ago. During the physical examination, tenderness in the right lower quadrant of the abdomen was felt. Furthermore, blood work showed leukocytosis and thrombocytosis. An X-ray examination revealed loculated pleural effusions. A WSD was placed, and pleural fluid analysis resulted in chylus. Sputum smears were negative. An abdominal CT scan revealed irregular thickening of the caecum wall extending to part of the large intestine and multiple surrounding lymphadenopathies. The patient was diagnosed with gastrointestinal TB and received category 1 anti-TB drugs.
Conclusion: The patient also underwent pulmonary rehabilitation and had improvements at the end of the hospitalization period.
Keywords: Extrapulmonary TB, Gastrointestinal TB, Loculated empyema, Pulmonary rehabilitation.
Article Details
How to Cite
Tambunan, T. F., Meilinda, A., Putri, N. M., Crisdayani, C. P., & Afta, A. A. (2023). Physical Medicine and Rehabilitation Management in Patient with Loculated Empyema, Pleural Effusion et causa Chylothorax on WSD, Gastrointestinal Tuberculosis and History of Drop-Out Pulmonary Tuberculosis: A Case Report. Indonesian Journal of Physical Medicine and Rehabilitation, 12(01), 20 - 32. https://doi.org/10.36803/indojpmr.v12i01.333
Section
Case Report
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tools for use in TB planning and programming [Internet]. Geneva: World
Health Organization; 2021 [cited 2022 Apr 18]. Available from: https://apps.who.int/
iris/handle/10665/3 44890
3. Ohene SA, Bakker MI, Ojo J, Toonstra A, Awudi D, Klatser P. Extra- pulmonary
tuberculosis: A retrospective study of patients in Accra, Ghana. Cardona PJ,
editor. PLOS ONE. 2019 Jan 9;14(1):e0209650.
4. Riley LE, Ataya A. Clinical approach and review of causes of a chylothorax. Respir
Med. 2019 Oct; 157:7–13.
5. Croitoru A, Motoc N Ștefania, Ianosi ES, Todea D, Stanciu I, Alexescu TG, et al.
Does respiratory rehabilitation improve the outcome of pleural effusion in pulmonology
department? case report series and short literature review. Munteanu C, editor.
Balneo Res J. 2019 Dec 10;10(Vol 10 No. 4):466–71.
6. Dourado VZ, Nishiaka RK, Simões MSMP, Lauria VT, Tanni SE, Godoy I, et al.
Classification of cardiorespiratory fitness using the six-minute walk test in adults:
Comparison with cardiopulmonary exercise testing. Pulmonology. 2021 Nov;27(6):500–8.
7. Febrianto D, Hadi U. Diagnostic and management problems of chylous effusion in a patient with newly- diagnosed tuberculosis. Curr Intern Med Res Pract Surabaya J. 2021 Aug 12;2(2):35.
8. Rajagopala S, Kancherla R, Ramanathan RP. Tuberculosis-associated chylothorax:
case report and systematic review of the literature. Respiration. 2018;95(4):260–8.
9. Gunjal SB, Shinde NK, Kazi AH, Mahajan AA. Effectiveness of deep breathing versus
segmental breathing exercises on chest expansion in pleural effusion. Int J Health
Sci. 2015;(7):7.
10. Canadian Lung Association, Canadian Thoracic Society, Public health agency of
Canada, centre for communicable diseases and infection control (Canada). Canadian
tuberculosis standards. 2014.
11. Lee CH, Lee MC, Lin HH, Shu CC, Wang JY, Lee LN, et al. Pulmonary tuberculosis
and delay in anti- tuberculous treatment are important risk factors for chronic obstructive
pulmonary disease. Pai M, editor. PLoS ONE. 2012 May 25;7(5):e37978.
12. Ravimohan S, Kornfeld H, Weissman D, Bisson GP. Tuberculosis and lung damage:
from epidemiology to pathophysiology. Eur Respir Rev. 2018 Mar 31;27(147):170077.
13. Devi HJG. Complications of pulmonary tuberculosis. Dep Respir Med
MS Ramaiah Med Coll Bangalore India. 2019 Apr;19.
14. Wirawan YR, Tansil CJ. Video- assisted thoracoscopic surgery in the treatment of
empyema: a case series. Bali Med J. 2021 Apr 1;10(1):89.
15. Garvia V, Paul M. Empyema. In: StatPearls [Internet]. Treasure Island (FL):
StatPearls Publishing; 2022 [cited 2022 May 24]. Available from: http://www.ncbi.
nlm.nih.gov/books/N BK459237/Rathod S, Samel DR, Kshirsagar P, Pokar
M. Thrombocytosis: can it be used as a marker for tuberculosis? Int J Res Med Sci.
2017 Jun 24;5(7):30
16. Sharma BB, Singh V. Pulmonary rehabilitation: An overview. Lung India.
2011;28(4):276-284. doi:10.4103/0970- 2113.85690
17. Bohannon RW, Crouch R. Minimal clinically important difference for change
in 6-minute walk test distance of adults with pathology: a systematic review. J
Eval Clin Pract. 2017;23(2):377-381.doi:10.1111/jep.12629
18. Zanini A, Crisafulli E, D’andria M, et al. Minimum clinically important difference
in 30-s sit-to-stand test after pulmonary rehabilitation in subjects with c o p d .
Respir Care. 2019;64(10):1261-1269. doi:10.4187/respcare.06694
19. Ries AL. Minimally clinically important difference for the UCSD shortness
of breath questionnaire, borg scale, and visual analog scale. COPD J Chronic
Obstr Pulm Dis.2005;2(1):105-110. doi:10.1081/COPD-200050655