An Unusual Case of Dysphagia and Chest Pain in a Non–HIV Patient: Esophageal Tuberculosis

Vahid, Bobbak; Huda, Nazmul; Esmaili, Ali

doi:10.1016/j.amjmed.2005.12.026

Cited by 12 publications

(5 citation statements)

References 7 publications

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“…In our series, all cases were secondary and we did not find even a single case of primary tuberculosis. Clinically, dysphagia is the most common presentation as also noted by others 2,8–10 . In our series, all patients had dysphagia, a quarter of them had associated odynophagia and more than half had constitutional symptoms.…”

Section: Discussionsupporting

confidence: 79%

“…Clinically, dysphagia is the most common presentation as also noted by others. 2,[8][9][10] In our series, all patients had dysphagia, a quarter of them had associated odynophagia and more than half had constitutional symptoms. Dysphagia may be due to compression by the lymph nodal mass, or associated mediastinal fibrosis or ulceration of esophagus, though altered motility may contribute to dysphagia.…”

Section: Discussionmentioning

confidence: 51%

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Esophageal tuberculosis: role of endoscopic ultrasound in diagnosis

Puri¹,

Khaliq

Kumar

et al. 2011

Diseases of the Esophagus

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Esophageal involvement by tuberculosis is rare and is commonly secondary to mediastinal lymph nodal involvement. Endoscopic ultrasound (EUS) is a good modality for evaluation of both esophageal wall and mediastinal lymph nodes. The objectives were to study the role of EUS in diagnosing esophageal tuberculosis, to differentiate primary from secondary form, and to assess the response. Retrospective analysis of data over 7 years (i.e. from 2003 to 2009) was used. The study was set in a tertiary care referral institute and focused on patients diagnosed with esophageal tuberculosis. Interventions used included endoscopy, EUS, EUS-FNA (fine needle aspiration) followed by antituberculosis treatment. The main outcome measurements were symptoms, endoscopic features, EUS features, pathological yield, and response to treatment. There were 32 cases of esophageal tuberculosis. The primary symptom was dysphagia, and endoscopy showed ulcers in 18/32 (56.25%) and extrinsic bulge in 20/32 (62.5%) in middle one third of esophagus. EUS showed lymph nodes adjacent to esophageal pathology in all cases. Subcarinal region was the most common site of lymphadenopathy and they were matted, heterogeneous with predominantly hypoechoic center. Histopathology of endoscopic biopsy of ulcers and EUS-FNA of lymph nodes provided the diagnosis of tuberculosis in 27/32 (84.35%). All patients were treated with antitubercular treatment and showed good clinical, endoscopic and endosonographic response. This is a retrospective study, and PCR and culture for Mycobacterium tuberculosis were not done. Esophageal tuberculosis does not appear to be a primary disease and is most likely secondary to mediastinal nodal tuberculosis. A conglomerated mass of heterogeneous with predominantly hypoechoic lymph nodes with intervening hyperechoic strands and foci on EUS appears to be characteristic of mediastinal tuberculosis.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 51%

Esophageal tuberculosis: role of endoscopic ultrasound in diagnosis

Puri¹,

Khaliq

Kumar

et al. 2011

Diseases of the Esophagus

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“…The most common symptom during esophageal tuberculosis is dysphagia (90% of cases), which was the main sign in our patient. Odynophagia, pyrosis, and chest pain may also be present[ 4 ]. The occurrence of coughing at mealtime should raise suspicion of an esotracheal or esophageal-mediastinal fistula, which is present in 13%-50% of cases[ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Isolated esophageal tuberculosis: A case report

Diallo¹,

Touré²,

Sarr³

et al. 2022

WJGE

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BACKGROUND Tuberculosis is endemic in Senegal. While its extra-pulmonary localization is rare, esophageal tuberculosis, particularly the isolated form, is exceptional. We report here a case of isolated esophageal tuberculosis in an immunocompetent patient. CASE SUMMARY A 58-year-old man underwent consultation for mechanical dysphagia that had developed over 3 mo with non-quantified weight loss, anorexia, and fever. Upper digestive endoscopy showed extensive ulcerated lesions, suggesting neoplasia. The diagnosis was confirmed by histopathology, which showed gigantocellular epithelioid granuloma surrounding a caseous necrosis. Thoracoabdominal computed tomography scan did not show another localization of the tuberculosis. The outcome was favorable with treatment. CONCLUSION Esophageal tuberculosis should be considered when dysphagia is associated with atypical ulcerated lesions of the esophageal mucosa, in an endemic area.

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“…Los síntomas clínicos asociados con la TE son diversos, e incluyen manifestaciones sistémicas (pérdida de peso, fiebre vespertina, escalofríos y malestar) y locales (dolor torácico anterior, disfagia y tos) (10,11) . Además, se han notificado algunos casos de sangrado por una fístula aortoesofágica (12) , y en ocasiones, la tos, la disnea y la fiebre alta pueden relacionarse con una fístula bronco-esofágica (13) .…”

Section: Discussionunclassified

Tuberculosis primaria de esófago: reporte de caso

Humpire

Lazo²,

Bejarano

et al. 2020

Horizmed

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Mujer de 60 años, natural de Tarma y procedente de Lima, con antecedentes de exposición a biomasas, contacto con paciente con tuberculosis, hipertensión arterial, arritmia cardiaca, y madre con cáncer de ovario. La paciente acude a consulta con un cuadro de siete meses de evolución caracterizado por disfagia progresiva, pérdida de peso de 15 kilogramos y fiebre vespertina. En la endoscopía previa mostró un tumor esofágico, y la tomografía reveló un engrosamiento tumoral a nivel de los tercios medio y distal del esófago, dependiente de la pared, y adenopatías mediastinales de 10x10 mm. Los demás órganos torácicos y abdominales no muestran alteraciones. En la última endoscopía se encuentra una lesión ulcerada en esófago y en el estudio patológico se observó una extensa inflamación crónica granulomatosa con células gigantes y necrosis; la prueba de Ziehl Neelsen para el bacilo de Koch (BK) fue negativa sin evidencia de lesión maligna y la reacción en cadena de la polimerasa (PCR) fue positiva para Mycobacterium. Se tomó una biopsia de las adenopatías mediante una ecoendoscopía, con una PCR negativa para Mycobacterium. Concluimos que el cuadro fue una tuberculosis esofágica primaria, y se inició el tratamiento con el esquema específico sensible a una dosis ajustada por peso.

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An Unusual Case of Dysphagia and Chest Pain in a Non–HIV Patient: Esophageal Tuberculosis

Cited by 12 publications

References 7 publications

Esophageal tuberculosis: role of endoscopic ultrasound in diagnosis

Esophageal tuberculosis: role of endoscopic ultrasound in diagnosis

Isolated esophageal tuberculosis: A case report

Tuberculosis primaria de esófago: reporte de caso

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