Hydropneumothorax is an uncommon but serious complication of pulmonary tuberculosis (PTB), often resulting from the rupture of a tuberculous cavity into the pleural space with bronchopleural fistula formation. Early diagnosis and optimal management are crucial to improving outcomes. A descriptive study was conducted over 18 months in 50 microbiologically confirmed PTB patients presenting with pneumothorax or hydropneumothorax at a tertiary care hospital in Punjab, India. Demographic, clinical, radiological, and microbiological data were recorded. Lung expansion was quantified using Light's Index at serial intervals up to 8 weeks. Statistical analysis was performed using Chi-square/Fisher exact tests; p<0.05 was considered significant. The mean age was 34.48±11.69 years, and 82% were male. All patients presented with breathlessness, 96% with chest pain, 68% with fever, and 62% with cough. New TB cases comprised 82%, recurrent 8%, and loss-to-follow-up 10%. The mean lung expansion time was 2.92±2.16 weeks. Significant associations were found between drainage status and lung expansion (p=0.01) and between type of TB and lung expansion (p=0.04). Complete radiological expansion was achieved in 76% of patients within 8 weeks. Surgical referral to the Cardiothoracic and Vascular Surgery Department was required in 24%. Hydropneumothorax in PTB predominantly affects young adult males and often requires prolonged drainage. Early intercostal tube drainage significantly improves lung expansion outcomes, particularly in new TB cases.
Kumar et al. (Mon,) studied this question.