Investigation of endobronchial tuberculosis diagnoses in 22 cases

Abstract

BackgroundEndobronchial tuberculosis (EBTB) is a special form of pulmonary tuberculosis. In spite of much progress in the diagnosis of this disease in past years, delayed or mistaken diagnosis is still commonly seen.ObjectiveThe aim of this study is to try to find out some useful clues for the diagnosis of EBTB, especially the early diagnosis.MethodsThe medical records of patients with EBTB were analyzed retrospectively. Results: The male-to-female ratio was 1:2.2 out of 22 patients. Patients aged below 60-years-old constituted 72.7% of the cases. 22.7% of these patients were smokers. The male-to-female ratio of smokers was 4:1. 68.2% of these patients tested all showed negative result for the HIV test. The frequent complaints were cough, sputum, shortness of breath and fever, and antibiotic treatments were usually inefficacious. Multiple lobes lesion, exudative shadow and atelectasis were the frequent radiological findings. Acid-fast bacilli staining for sputum smear was positive in only 13.6% of these patients. Tuberculin skin test was positive in 59.1% of these patients. Granular lesion was the most common bronchoscopic appearance in these patients. Histological changes showed distinctive tuberculose lesion in 72.2% of 18 patients undergoing bronchoscopic biopsy.ConclusionThe diagnosis of EBTB is easily delayed or mistaken because of nonspecific clinical manifestations and the low incidence of positive acid-fast bacilli staining. A high index of awareness of this disease is required for diagnosis. Bronchoscopy should be performed as soon as possible in suspected patients, especially when patients present positive tuberculin skin test or no response to antibiotic treatments.

Bronchoscopic diagnostic procedures and microbiological examinations in proving endobronchial tuberculosis

“…The mean age was 53.1 years, and 38.8% of the patients were under 45 years of age, which is also in keeping with data in the literature. (8)(9)(10)(11) In the present study, the most common EBTB subtype was actively caseating EBTB, as has been reported in some previous studies. (8,11) However, in a study conducted by Qingliang et al, (10) the granular Results expressed as n of cases in which granulomatous inflammation was proven.…”

“…(10) The ulcerative and fibrostenotic subtypes were the least common in our study, both being seen in 5.6% of the patients.…”

“…In our sample of patients with EBTB, the female-to-male ratio was 1.57:1, which is consistent with the preponderance of females reported in other studies of EBTB. (8)(9)(10)(11) EBTB usually affects adults, although younger and elderly patients can be affected, EBTB patient ages ranging from 14 to 81 years. (12) In the present study, patients ranged from 16 to 83 years of age.…”

A Comparison of yield of bronchoalveolar lavage fluid examination versus post bronchoscopic sputum examination in the diagnosis of sputum smear negative pulmonary tuberculosis

“…In our study, 36 cases had history of smoking, among these 30 cases (42%) were active smokers, while 6 (8%) quitted smoking for more than one year and 36 of them (50%) had never smoked before. This was slightly higher than the study done by X Qingliang et al [13] where history of smoking was present in 22.7%.…”

Endotracheal Tuberculosis and Aspergillosis Co-Infection Manifested as Acute Respiratory Failure: A Case Report

“…It can affect any part and layer of the tracheobronchial wall and diagnosis is made by microbiological and histopathological examination [2]. The incidence of ETB ranges from 10 to 40% in cases with active pulmonary tuberculosis [3][4][5]. Diagnosis is frequently delayed, increasing the risk of complications such as erosion, stenosis, atelectasis or bronchiectasis [4].…”