Endobronchial Tuberculosis Presenting As Asthma

Williams, Dave J.; York, Ernest L.; Nobert, Ewa; Sproule, Brian J.

doi:10.1378/chest.93.4.836

Cited by 48 publications

(27 citation statements)

References 12 publications

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“…Empty or open pulmonary tuberculosis is often accompanied by bronchial TB. It had been shown that 18% of tuberculosis patients had an active TB infection of the inner membrane of the bronchus [18].…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment efficacy in 172 cases of tuberculosis-destroyed lungs

Bai

Hong

Gong

et al. 2011

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES: Compared to the use of anti-TB drugs for the treatment of tuberculosis (TB), surgery is destructive and is associated with higher risk. Whether surgery is needed for the treatment of TB-destroyed lungs (for short: destroyed lungs) is still controversial and unresolved in the clinic. METHODS:Retrospective analysis of treatment efficacy was performed on 172 cases of destroyed lungs (176 surgeries) in the Thoracic Surgery Department of our hospital from April 1992 to June 2010. RESULTS:A total of 83 male and 89 female patients was analyzed. The youngest patient was 7 years old, and the oldest was 72 years old, with a mean age of 38.4 years. A total of 120 cases had a preoperative cough, 31 cases had fever, and 42 cases had hemoptysis. A total of 49 cases was positive for Mycobacterium tuberculosis by sputum test before surgery, yielding a positive TB rate of 28.5% (49/172). A total of 116 patients had a destroyed left lung and 56 cases had a destroyed right lung. In all, 110 cases underwent total pneumonectomy, 37 pleuropneumonectomy, one lobectomy, 10 residual lobectomy, two total pneumonectomy and tracheoplasty, 11 cases bronchopleural fistula (BPF) repair and other surgeries, and one case underwent thoracoplasty. A total of four patients underwent thoracoplasty 30 days after surgery due to a thoracic cavity infection or empyema. The overall perioperative mortality rate was 2.9% (5/172). The surgical complication rate was 18.6% (32/172). The sputum negative conversion rate was 87.8% (43/49), and the clinical cure rate was 91.9% (158/172). CONCLUSIONS:Our findings suggested that surgical treatment efficacy in destroyed lungs was satisfactory with strict surgical indications, standard preoperative anti-TB treatment, adequate preoperative preparation, and careful intraoperative operations.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment efficacy in 172 cases of tuberculosis-destroyed lungs

Bai

Hong

Gong

et al. 2011

European Journal of Cardio-Thoracic Surgery

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“…The sputum-smear negative patients should undergo bronchoscopy for early diagnosis and treatment; 33% of the active tuberculosis patients in this study were sputum smear negative. The sputum smear or white coating smear is often negative for AFBeven in bronchoscopically active lesions, such as in our Group C patients, and bronchoscopic biopsy should be performed (4,9,(13)(14)(15). Furthermore, bronchoscopy might be indicated in a very small number of patients with isolated persistent cough, which is the most commonchief complaint in EBTB (3,4,9,15).…”

Section: Discussionmentioning

confidence: 86%

A Prospective Study of Bronchoscopy for Endotracheobronchial Tuberculosis.

et al. 1996

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To clarify the role of bronchoscopy for endotracheobronchial tuberculosis (EBTB), we performed a prospective study in 45 patients with active pulmonary tuberculosis, in 15 (33%) of whombronchoscopic findings related to EBTBwere seen. The findings were classified into six types: edematous hyperemic, submucosal nodule, ulcerative (shallow and deep), polypoid, cicatrical, and compression type. Each of these types was related to the healing process and outcome after antituberculosis chemotherapy. Serial bronchoscopy revealed that lesions less advanced than the deep ulcerative type responded to chemotherapy; the deep ulcerative and polypoid types progressed to cicatrical bronchostenosis despite chemotherapy. In the follow-up of patients with lesions of the deep ulcerative and polypoid types, serial bronchoscopy after chemotherapy is recommended;these patients also require adjunctive therapy to prevent cicatrical bronchostenosis. (Internal Medicine 35: 698-703, 1996)

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“…Unrelenting cough with or without fever is the predominant symptom [1][2][3][4]. Sometimes patients may present with wheeze due to endobronchial obstruction or bronchostenosis mimicking asthma [5], foreign body aspiration [6], and malignancy [7]. Thus, a clinical diagnosis is very difficult, and bronchoscopy is crucial in early diagnosis of EBTB.…”

Section: Discussionmentioning

confidence: 99%

“…Recently EBTB was found in 4.1% of unselected patients and in 54% of newly diagnosed pulmonary tuberculosis patients undergoing flexible bronchoscopy [3,4]. In the absence of parenchymal disease or positive sputum microbiology, patients may be erroneously treated for other causes of chronic cough leading to potential delay in diagnosis and increased risk of transmission in the community [5][6][7]. There is no consensus on the duration of antitubercular therapy or the use of corticosteroids in EBTB.…”

Section: Introductionmentioning

confidence: 99%

Actively Caseating Endobronchial Tuberculosis Successfully Treated with Intermittent Chemotherapy without Corticosteroid: A Report of 2 Cases

Panigrahi

Pradhan

Mishra

et al. 2017

Advances in Respiratory Medicine

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Tuberculous infection of the tracheobronchial tree confirmed by microbiological or histopathological evidence with or without parenchymal involvement is known as endobronchial tuberculosis. Chronic cough is the predominant symptom. Expectorated sputum examination for acid fast bacilli is often negative leading to delay in diagnosis. Therefore, bronchoscopy is crucial for early diagnosis and evaluation of the extent of disease. Bronchostenosis is a significant complication of endobronchial tuberculosis that may be present at the time of diagnosis or develops during the course of treatment. Previously, corticosteroids have been used along with antitubercular therapy to prevent or reduce the extent of bronchostenosis; however, their role is debatable as bronchostenosis often develops despite the use of corticosteroids. Furthermore, the duration of treatment varied from 6-9 months of daily therapy in previous series and little is known about efficacy of intermittent antituberculous therapy. Here we report two cases of actively caseating endobronchial tuberculosis successfully managed with six months of intermittent oral antitubercular therapy without corticosteroids.

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Endobronchial Tuberculosis Presenting As Asthma

Cited by 48 publications

References 12 publications

Surgical treatment efficacy in 172 cases of tuberculosis-destroyed lungs

Surgical treatment efficacy in 172 cases of tuberculosis-destroyed lungs

A Prospective Study of Bronchoscopy for Endotracheobronchial Tuberculosis.

Actively Caseating Endobronchial Tuberculosis Successfully Treated with Intermittent Chemotherapy without Corticosteroid: A Report of 2 Cases

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