Full-body subcutaneous emphysema in chronic tuberculosis post-chest tube insertion: a rare case report
Main Article Content
Keywords
bullectomy, intercostal drain, subcutaneous emphysema, tuberculosis
Abstract
Introduction: Subcutaneous emphysema (SCE) is a rare complication associated with respiratory infections, physical trauma, or iatrogenic causes, including invasive procedures like thoracotomy and intercostal drain (ICD) insertion. Although commonly seen in trauma and post-surgical cases, the occurrence of extensive SCE in patients with chronic pulmonary tuberculosis (TB), particularly due to bullous rupture and secondary pneumothorax, is infrequent. This study aimed to present a case of extensive subcutaneous emphysema in a patient with chronic tuberculosis (TB) complicated by bullous rupture and secondary pneumothorax.
Case presentation: A 31-year-old male with a 5-year history of pulmonary TB presented with progressive shortness of breath and extensive subcutaneous emphysema affecting the face, neck, thorax, abdomen, scrotum, and extremities, two days after a thoracotomy and chest tube insertion. Computed tomography (CT) revealed pneumothorax and multiple bullae in the lungs, with the largest measuring 4.6 × 3.5 × 3.2 cm. The patient was managed with anti-TB therapy, chest tube revision, and video-assisted thoracoscopic surgery (VATS) bullectomy, resulting in gradual clinical improvement and stable discharge on day 24.
Conclusion: This case highlights the rare but severe complication of extensive SCE in a TB patient with bullous rupture and pneumothorax. It underscores the importance of early recognition of such complications in TB patients, careful monitoring during chest tube management, and adherence to anti-TB therapy to mitigate long-term pulmonary damage and prevent life-threatening sequelae.
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