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VOLUME 10 , ISSUE 1--4 ( January-December, 2024 ) > List of Articles

CASE SERIES

Three Different Types of Endobronchial Tuberculosis: A Case Series

Ihjaz Mohamed, Mohanakrishnan D, Chandrasekar C, Balamurugan S

Keywords : Bronchoscopy, Bronchostenosis, Case Report, Endobronchial tuberculosis

DOI: 10.5005/jp-journals-10045-00299

License: CC BY-NC 4.0

Published Online: 15-10-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aim and background: Endobronchial tuberculosis (EBTB) is a tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence. It is part of pulmonary tuberculosis (PTB) not commonly diagnosed because bronchoscopy is not routinely done in PTB. Chung and Lee classified EBTB into seven types. Case description: Case 1: An 18-year-old female presented with a left collar stud abscess and cough with expectoration for 1 month. On examination, left interscapular crepitations were heard. X-ray and CT-thorax showed lingular segment collapse–consolidation. Pus from the abscess Xpert MTB/RIF (Mycobacterium tuberculosis/Rifampicin) was detected. Fiberoptic bronchoscopy (FOB) was done, which showed total occlusion of superior lingular segment bronchus (tumorous EBTB). Xpert MTB/RIF detected MTB in bronchial lavage. Case 2: An 18-year-old boy presented with cough with expectoration, fever, dyspnea, and weight loss of about 6 kg. On examination, left interscapular monophonic wheeze was heard. X-ray and CT-thorax showed a lateral segment of left lower lobe collapse–consolidation. His sputum acid-fast bacilli (AFB) was negative; hence, FOB was done, which showed partial obstruction of lateral segment bronchus of the lower lobe (actively caseating EBTB). Case 3: A 27-year-old female complained of cough with expectoration for 2 weeks. Her sputum AFB was scanty and Xpert MTB/RIF detected. CT-thorax showed small ectatic changes in the lingular segment. Because of the disparity of CT-thorax and sputum results, FOB was done, which showed a sago-grain appearance of the lower part of the trachea (granular EBTB). Conclusion: High clinical suspicion is required to diagnose EBTB since routine bronchoscopy is not performed in PTB patients. Follow-up bronchoscopy may be required since these patients might develop bronchostenosis later. Clinical significance: In our case series, we have shown the clinical features, diagnosis and management of EBTB, which helps to suspect EBTB and perform bronchoscopy on such patients.


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