RUPTURE OF THERAPEUTIC OLEOTHORAX LEADING TO PARAFFIN OIL ASPIRATION AND DISSEMINATION OF TUBERCULOSIS - A FATAL LATE COMPLICATION OF TUBERCULOSIS THERAPY IN THE 1940S

In the 1940s, oleothorax (paraffin oil instillation) was widely used t o treat patients with apical tuberculosis. The oil plombage should hav e been removed after a few years; however, since oleothoraces were usu ally asymptomatic, removal was uncommon. These in the meantime elderly patients are at risk of late complications, such as rupture of the ol eothorax and aspiration of oil. We report the case of a 69-year-old ma n with a spontaneous rupture of an oleothorax leading to oil aspiratio n, lipid pneumonia and culture-proven disseminated tuberculosis with f atal outcome. Unexpected positive PCR for M. tuberculosis-DNA in trach eal secretions was one of the leading signs in this case. Thus oil plo mbage in patients with oleothorax may be ''time bombs''. Primary physi cians should be aware of this life-threatening complication.