Diagnosis and Management of Endobronchial Tuberculosis.

Kurasawa, Takuya; Kuze, Fumiyuki; Kawai, Mitsuru; Amitani, Ryoichi; Murayama, Takako; Tanaka, Eisaku; Suzuki, Katsuhiro; Kubo, Yoshiro; Matsui, Yasunori; Sato, Atsuo; Yuba, Yoshiaki

doi:10.2169/internalmedicine.31.593

Cited by 31 publications

(22 citation statements)

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“…Of these 62 patients, 43 patients continued to have endobronchial tuberculosis by the end of treatment; and despite appropriate treatment with anti-tuberculous therapy approximately 50% (22/43 patients) of the patients developed bronchostenosis. This pattern is consistent with other previous studies (30)(31)(32). Among 19 cases with granular, ulcerative, and nonspecific bronchitic endobronchial tuberculosis that did not show luminal narrowing of the bronchus at diagnosis, 17 cases healed without bronchostenosis, while 2 cases of granular type still developed bronchial stenosis after treatment.…”

Section: Treatmentsupporting

confidence: 92%

Tracheobronchial tuberculosis

Pathak¹,

Shepherd²,

Shojaee³

2016

J. Thorac. Dis.

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Tracheobronchial tuberculosis (TBTB) is reported in approximately 10% to 39% of the patients with pulmonary tuberculosis. It is defined as the tubercle infection of the trachea and or bronchi. Due to its non-specific presentation, insidious onset and normal chest radiography in about 10-20% of the patients, the diagnosis is delayed. Bronchoscopy is the most definite method of diagnosis which provides adequate specimens for microbiological and histopathological diagnosis. Tracheobronchial stenosis is one of the most common long term complications of TBTB resulting in significant morbidity. It is estimated that 90% of patients with TBTB have some degree of tracheal and or bronchial stenosis. In this review article, we will discuss the pathogenesis, symptoms, imaging, bronchoscopic findings, and treatment of TBTB and management of tracheobronchial stenosis.

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Section: Treatmentsupporting

confidence: 92%

Tracheobronchial tuberculosis

Pathak¹,

Shepherd²,

Shojaee³

2016

J. Thorac. Dis.

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“…The patients’ characteristics, including demographic data, symptoms, initial diagnoses, and radiological, bronchoscopic and microbiological features, were reviewed and evaluated retrospectively. Bronchoscopic findings were categorized according to Chung’s classifications [4]. The results are presented as mean and percentage of patients.…”

Section: Methodsmentioning

confidence: 99%

“…However, since bronchoscopy is not routinely performed in patients with tuberculosis, the true incidence of EBTB is likely underestimated. There is only one study in the literature in which bronchoscopy was performed in all patients with active pulmonary tuberculosis, and it reported an incidence of EBTB as high as 50% [4]. EBTB continues to be a clinical challenge, especially in endemic areas, since it may mimic a variety of pulmonary diseases such as bronchogenic carcinoma, pneumonia, or bronchial asthma.…”

Section: Introductionmentioning

confidence: 99%

Endobronchial tuberculosis: histopathological subsets and microbiological results

Özkaya

Bilgin

Fındık

et al. 2012

Multidiscip Respir Med

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BackgroundEndobronchial tuberculosis (EBTB) is defined as a tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence, with or without parenchymal involvement. Bronchoscopic appearances of EBTB have been divided into seven subtypes: actively caseating, edematous-hyperemic, fibrostenotic, tumorous, granular, ulcerative, and nonspecific bronchitic. However, information for establishing a definite microbiological diagnosis in each of these categories is lacking.We aimed to present bronchoscopic appearances and percentages for the EBTB subtypes and to compare bronchoscopic appearances with microbiological positivity in bronchial lavage fluid.MethodsFrom 2003 to 2009, 23 biopsy-proven EBTB patients were enrolled in the study. Diagnosis of EBTB was histopathologically confirmed in all patients.ResultsThe commonest subtype was the edematous-hyperemic type (34.7%); other subtypes in order of occurrence were: tumorous (21.7%), granular (17.3%), actively caseating (17.3%), fibrostenotic (4.3%), and nonspecific bronchitic (4.3%). Although all patients were sputum-smear-negative for acid-fast bacilli (AFB), 26% of patients were smear-positive for AFB in the bronchial lavage fluid. The bronchial lavage fluid grew Mycobacterium tuberculosis in 39.1% of all patients.The bronchial lavage smear positivity for AFB in the bronchial lavage fluid was 75%, 25%, 20%, 12.5%, 0%, and 0% for the granular, actively caseating, tumorous, edematous-hyperemic, fibrostenotic, and nonspecific bronchitic subtypes of EBTB, respectively. Culture positivity for Mycobacterium tuberculosis in bronchial lavage fluid was 75%, 50%, 40%, 25%, 0%, and 0%, respectively.ConclusionThe commonest subtype of EBTB was the edematous-hyperemic subtype. The granular type had the highest smear positivity and culture positivity for Mycobacterium tuberculosis in bronchial lavage fluid. Bronchoscopy should be performed in all patients suspected to have EBTB.

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“…Rikimaru showed that the healing time of ulcerous lesions was shorter and bronchial stenosis was less severe, in patients treated with aerosol therapy, consisting of streptomycin 100 mg, dexamethasone 0.5 mg and naphazoline 0.1 mg administered twice-daily along with conventional oral therapy (39). In another study submucosal methylprednisolone injection also demonstrated resolution of EBTB (25,40). The role of corticosteroids needs to be further evaluated in larger prospective trials before its regular use in adult patients.…”

Section: Treatmentmentioning

confidence: 99%