Esophageal tuberculosis with Esophagopulmonary fistula: A case report

Abstract

Esophageal tuberculosis (TB) is a rare condition that accounts for only 2.8% of all cases of gastrointestinal TB [1]. It usually occurs as a result of direct spread from mediastinal lymph nodes and rarely from the lungs or bloodstream. Two types of esophageal TB have been described: Primary and secondary [2]. The secondary type is more common as primary involvement is extremely rare due to the intrinsic protective properties of the esophagus [3]. If left untreated, esophageal TB can lead to bleeding, perforation, fistula formation, aspiration pneumonia, fatal hematemesis, traction diverticula, and esophageal strictures [4]. Thus, through this case report, we wish to emphasize that it is imperative to keep esophageal TB as an important differential diagnosis, particularly in cases of dysphagia [5]. CASE REPORTA 27-year-old female presented to our tertiary care center with complaints of cough (especially after eating), dysphagia, decreased appetite, and undocumented weight loss (in form of loosening of clothes) for the past one month. She denied any history of fever, hemoptysis, hematemesis, nasal regurgitation, hoarseness or change in voice, dyspnea, or any chest pain.Pallor was present but the rest of the physical examination was unremarkable. Pulse rate was 96/min with a regular rhythm and no radioradial or radiofemoral delay, respiratory rate was 22/min, blood pressure was 122/86 mmHg in the right arm in the supine position, and weighed 52 kg on admission.