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Allen S. Johnson
JAMA. 1935;105(4):269-270. doi:10.1001/jama.1935.92760300001007a.
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The following case of spontaneous rupture of a cold abscess of the chest wall with drainage of a pleural effusion is reported because of the apparent rarity of the phenomenon. Meade1 says in regard to a tuberculous abscess of the soft parts of the chest wall that "whether it starts in the pleura or other deep seated layer the process always advances outward, either directly or after a lateral deviation. Practically all writers agree that inward spread is unknown." In the case herewith reported, however, this abscess developed spontaneously, not in a needle tract after aspiration, and ruptured both inward and outward, thereby replacing the pleural effusion with a pneumothorax. The studies of Leggett2 and Emerson3 indicate that such a sequence of events is most unusual in the case of a pleural effusion not secondarily infected, and I can find no report of such a phenomenon in an extensive search


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