Case Report of International Journal of Case Reports
Fatal diffuse pleural calcification due to Tuberculosis- An unexplained entity
Sugeesha Wickramasinghe, Bandu Gunasena, Sumudu Palihawadene
National Hospital for Respiratory Diseases, Welisara, Sri Lanka
Diffuse pleural thickening has many causes and often need to be diagnosed early as delay in treatment can be lethal. Diffuse pleural thickening can be due to calcifications and may occur as a result of chronic infections including Tuberculous effusion. Primary pleural calcification due to Tuberculosis is extremely rare. A 28 year old patient was presented with exertional dyspnea, chronic cough and pleuritic type chest pain for a period of 4 months. CXR showed left sided diffuse pleural calcifications and ultrasonography showed calcified pleura with thick echogenic material suggestive of an empyema. Further evaluation with a CECT showed left sided diffusely calcified, septated pleura with empyema and contralateral early pleural and peritoneal calcification. Pleural aspiration showed a hemorrhagic exudative lymphocytic effusion with high ADA titer. Cytology did not reveal malignant cells. His serum calcium level was normal. He was diagnosed to have extra-pulmonary tuberculosis and was treated with standard anti TB treatment with an intercostal tube drainage. Despite TB treatment he passed away due to respiratory distress caused by pleural thickening. This case highlights the importance of timely initiation of anti TB treatment and the capacity of Tuberculosis to cause diffuse pleural calcification which can be fatal in an untreated setting.
Keywords: Fatal diffuse pleural calcification, Tuberculosis
How to cite this article:
Sugeesha Wickramasinghe, Bandu Gunasena, Sumudu Palihawadene. Fatal diffuse pleural calcification due to Tuberculosis-An unexplained entity. International Journal of Case Reports, 2020 4:172. DOI: 10.28933/ijcr-2020-10-0105
1. Udwadia ZF, Sen T. Pleural tuberculosis: an update. Curr Opin Pulm Med 2010;16:399-406.
2. Atasoy C, Kaya A, Fitoz S, et al. Discrete pleural nodules associated with a parasternal mass: an unusual manifestation of tuberculosis. J Thorac Imaging 2002;17:74-7.
3. Hong-Tao Tie, Min Zhang. Bilateral diffuse pleural plaque with calcifications in pleural tuberculosis. Mediastinum 2018:4(2)
4. Lazarus AA, McKay S, Gilbert R. Pleural tuberculosis. Dis Mon. 2007;53(1):16–21
5. Wong PC. Management of tuberculous pleuritis: can we do better? Respirology. 2005;10 (2):144–48.
6. G Sahana, Vishak Acharya, Santosh Rai, Nishanth Baliga. A Rare Case of Primary Calcific Pleural Tuberculosis – A Case Report. Journal of Clinical Diagnostics and Research. 2017; 11(7)