PMCT aided diagnosis of spontaneous pneumothorax in a case of disseminated pulmonary tuberculosis

Background

Tuberculosis remains one of the leading causes of death from a single infectious agent, second only to COVID-19, as stated by WHO Global Tuberculosis Report 2021. Tuberculosis can present as parenchymal lesions, vascular lesions, mediastinal lesions, airway lesions, pleural lesions and chest wall lesions. One such presentation is the development of secondary spontaneous pneumothorax.

Case report

A 32-year-old male, found lying in unresponsive state was taken to Emergency department, where he was declared as brought dead. The autopsy revealed diffuse granular lesions on both lungs with purulent secretions. No evident emphysematous bullae or parenchymal breach or rib fractures were appreciable in macroscopic examination. Post mortem Computed tomography revealed unilateral spontaneous tension pneumothorax on the left side with compression of great vessels and mediastinal structures. Histopathological examination further confirmed disseminated tuberculosis in both lungs.

Conclusion

Deaths involving spontaneous secondary pneumothorax is so rare for clinicians that forensic pathologists are in a prime position for reporting such findings. In addition, PMCT plays an important role in diagnosing tension pneumothorax and the compression of mediastinal structures as compared to the traditional autopsy