CTICasesTuberculous Empyema
Imaging findings
Chest CT shows a chronic, loculated left pleural fluid collection with thick, irregular pleural calcification along both the visceral and parietal pleural surfaces (empyema). Abdominal CT shows diffuse miliary nodules coating the mesentery, peritoneum, and liver. Biopsy of the peritoneal nodules confirms acid-fast bacilli (AFB) consistent with Mycobacterium tuberculosis.
Key takeaways
Tuberculous empyema is a chronic, active tuberculous infection of the pleural space, characterized by a thick-walled, calcified pleural collection. It can be associated with disseminated abdominal tuberculosis (tuberculous peritonitis), presenting with miliary peritoneal deposits. Diagnosis is established by demonstrating AFB or positive cultures in pleural fluid or pleural/peritoneal biopsies.
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