Parietal thoracic tuberculosis in thirteen HIV-negative patients

Panetal thoracic abscess formation of a tuberculous nature is a rare form o f extrapulmonary tuberculosis, usually described in cases of severe tubercu losis encountered in HIV-infected patients. We report 13 cases of purietal tuberculosis in patients without HIV infection who were investigated betwee n October 1988 and December 1999. During this period, we cared for 2 663 pa tients with tuberculosis. The series included 9 women and 4 men age 17 to 6 0 years, mean age 39 years. The clinical aspect of the parietal abscess was variable. Cold fluctuating abscess was dominant in 10 cases. In 3 cases, t he parietal abscess had a hard consistence simulating a malignant tumor The parietal abscess was in a posteriosuperior or posteriobasal location in 4 cases, and in an anterosuperior, anterobasal or axiliary location in 6. Mul tiple thoracic abscesses were observed in only 3 cases, The size of the abs cess varied from 2 to 2.5 cm. Radiologically rib damage was present in 4 ca ses, scapular damage in 1, with bone 6 sis in 3 cases. Other localizations of tuberculosis were observed in 4 cases. one patient had multiple peripher al no. ie enlargement, another had parenchymal lung damage and a third had a vertebral localization. Culture of abscess pus provided the diagnosis in 10 cases, the diagnosis was confirmed by pathology in 8 cases on a biopsy o f the abscess border Anti-tuberculosis drugs allowed successful recovery in all patients. We analyzed the clinical aspects of cold thoracic abscesses and discuss differential diagnosis. Early diagnosis and treatment is essent ial.