Tuberculous bronchonodal fistula in adult patients: CT findings

Abstract

Bronchonodal fistula can occur as a complication of active pulmonary TB with TB lymphadenitis in adult patients, especially in the elderly. The fistulas usually involved the right side. The lobar bronchus was frequently involved on the right side and the main bronchus on the left side.

Adenobronchial fistula secondary to tuberculosis in an immunocompetent adult patient

“…It is important to mention the value of chest CT in the diagnosis of this condition. In a study by Park et al , the tomographic characteristics were described in seven patients with active pulmonary tuberculosis and adenobronchial fistula, concluding that the fistula occurs as a complication of extensive pulmonary tuberculosis with involvement of more than four lobes, occurring mainly in patients older than 72 years old and mainly involving the right bronchial side 3. In our case there is only involvement of RIL and the involvement was of both main bronchi in an immunocompetent patient.…”

Tuberculosis presenting as isolated bronchonodal fistula in a patient with systemic lupus erythematosus

“…Tuberculous bronchonodal fistula is formed by erosion of lymph nodes into adjacent airway through inflammation and necrosis. [ 14 ] Tuberculous bronchonodal fistula in adults is extremely rare, contrary to that in children. Park et al [ 14 ] have reported CT and clinical characteristics of tuberculous bronchonodal fistula in 7 adult patients.…”

“…[ 14 ] Tuberculous bronchonodal fistula in adults is extremely rare, contrary to that in children. Park et al [ 14 ] have reported CT and clinical characteristics of tuberculous bronchonodal fistula in 7 adult patients. In their study, all patients were over 70 years old without major immunosuppressive diseases.…”

“…Therefore, the physician had to repeat bronchoscopic examination after reviewing and discussing CT findings. According to Park et al, [ 14 ] bronchoscopist can overlook the presence of fistula because the fistulous tract is often concealed and covered by exudate or necrotic tissue. They might consider the disease as a mere endobronchial TB.…”

“…Tuberculous bronchonodal fistula can be treated with anti-TB medication. [ 14 ] According to microbiological examination of sputum and bronchial aspirates, anti-TB medication was started with isoniazid, ethambutol, pyrazinamide, and moxifloxacin. Follow-up bronchoscopy showed decreased size of fistula.…”