No abstract

Tuberculosis (TB) and pneumonia are among the top-10 global causes of death worldwide. Many studies highlight the diagnosis delay of TB in patients with an initial presentation of pneumonia. We present a case of a 16-year-old boy who complains of a productive cough associated with blood-streaked sputum for one-month duration. Having pulmonary tuberculosis (PTB) contact three years ago puts him at risk of a similar infection. Despite the episodes of missed appointments in serial follow-ups, we were ultimately able to exclude PTB in this patient.

Endobronchial Tuberculosis is hazardous in causing circumferential narrowing of tracheobronchial tree despite the eradication of tubercle bacilli in the initial insult from Pulmonary Tuberculosis. They may present as treatment resistant bronchial asthma and pose challenge to airway management in the acute setting. We present a 25 year-old lady who was newly diagnosed bronchial asthma with a past history of Pulmonary Tuberculosis that had completed treatment. She presented with sudden onset of difficulty breathing associated with noisy breathing for 3 days and hoarseness of voice for 6 months. Due to resistant bronchospasm, attempts were made to secure the airway which led to unanticipated difficult intubation and ventilation. Subsequent investigations confirmed the diagnosis of Endobronchial Tuberculosis and patient was managed successfully with anti TB medication, corticosteroids and multiple sessions of tracheal dilatation for tracheal stenosis. This case highlights the unusual cause of difficulty in intubation and ventilation due to Endobronchial Tuberculosis, which required medical and surgical intervention to improve the condition.