Tuberculous Pleuro-Cutaneous Fistula

Introduction: The pleural fistulas are defined by a fistula communicating the pleural cavity to the chest wall. They often occur in the immunocompromised individuals with pyogenic infections, much more rarely in immunocompetent patients with tuberculosis. Materials and Methods: Between February 2010 and August 2012, five patients were followed up and operated for tuberculous pleuro-cutaneous fistula in the thoracic surgery department of University Hospital Hassan II of Fez. Results: These were 2 female and 3 male patients, with the average age of 39 years, and the age ranging from 18 years to 60 years. One patient was operated on for tuberculous empyema; there are 20 years and another 15 years ago drained for tuberculous empyema. All patients had a fistula necessitated operating on an average of three years, with extremes ranging from 15 days to 6 years. The radiological assessment had objectified chronic pleural pocket in one case, a costal osteitis in 2 cases, multiple cystic lesions in one case and apseudotumor appearance and endo exothoracique in another. Patients had benefited from draining the abscess with fistula resection associated with a rib resection in 2 cases and thoracostomy with lung prosthesis in one case. Conclusion: Tuberculous pleuro-cutaneous fistula is a rare pathological entity, occurring most often in an array of multifocal tuberculosis, or as a complication of surgery for tuberculous empyema.