Left main bronchus compression as a result of tuberculous lymphnode compression of the right‐sided airways with right lung volume loss in children

Andronikou, Savvas; Wyk, M J van; Goussard, Pierre; Gie, Robert P.

doi:10.1002/ppul.22728

Cited by 3 publications

(3 citation statements)

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“…TB‐BOF is a rare complication of TB and is usually fatal 7 . The available literature describing the clinical features, diagnosis, management, outcomes, and complications of BOF in intrathoracic tuberculosis in children is limited to case resports 8‐13 …”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6] TB-BOF is a rare complication of TB and is usually fatal. 7 The available literature describing the clinical features, diagnosis, management, outcomes, and complications of BOF in intrathoracic tuberculosis in children is limited to case resports. [8][9][10][11][12][13] The aim of this study is to describe the clinical course, radiological and bronchoscopic images, treatment and the outcome of a case series of children with BOF caused by MTB.…”

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confidence: 99%

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Management of children with tuberculous broncho‐esophageal fistulae

Goussard

Andronikou

Morrison

et al. 2020

Pediatric Pulmonology

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Introduction Broncho‐esophageal fistula (BOF) is a rare complication of Mycobacterium tuberculosis (MTB). TB‐associated BOF presents either as acute respiratory failure, aspiration pneumonia or as a complication of surgical decompression of thoracic lymph nodes. Methods All children with TB‐ associated BOF were included. TB was diagnosed if MTB was cultured from respiratory secretions, Ziehl‐Neelsen (ZN) smear was positive, GeneXpert MTB/RIF was positive or a chest radiograph revealed radiographic features typical of TB. BOF was diagnosed by a contrast swallow study and/or flexible bronchoscopy. Chest computed tomography (CT) scan was performed, if required. Results Total of 20 children were diagnosed with TB‐associated BOF between 1999 and 2019, with a 75% survival. A total of 85% BOF involved the left main bronchus. A total of 80% of patients were MTB culture or ZN smear‐positive. Chest X‐ray abnormalities included: extensive parenchymal disease (80%) and lymph gland enlargement (45%). CT features included visualization of the BOF (60%), esophageal air (73%) and pneumomediastinum (40%). BOF closure was achieved by surgical closure (46%), spontaneous closure (26%), fibrin glue (13%), and esophageal stent (13%). Multivariant regression analysis showed that C‐ reactive protein (CRP), albumin and CRP/albumin ratio were associated with mortality. Conclusion Most TB‐associated BOF are left‐sided. It presents either acutely, with respiratory failure, or with chronic respiratory symptoms of aspiration. Children requiring invasive ventilation have high mortality. Most TB‐associated BOF requires surgical intervention, although the use of fibrin glue offers an attractive alternative option.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Management of children with tuberculous broncho‐esophageal fistulae

Goussard

Andronikou

Morrison

et al. 2020

Pediatric Pulmonology

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“…One of the potential complications of pulmonary tuberculosis (TB) in children is compression of central airways by enlarged mediastinal lymph nodes. Andronikou and co‐authors hypothesized, based on a study of CT findings in children with TB, that mediastinal shift from right lung volume loss is associated with compression of the left main stem bronchus due to narrowing of the pulmonary artery bifurcation angle.…”

Section: Introductionmentioning

confidence: 99%

Pediatric pulmonology year in review 2014: Part 2

Noah

Auten

Schwarze

et al. 2015

Pediatric Pulmonology

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Our journal covers a broad range of research and scholarly topics related to children's respiratory disorders. For updated perspectives on the rapidly expanding knowledge in our field, we will summarize the past year's publications in our major topic areas, as well as selected publications in these areas from the core clinical journal literature outside our own pages. The current review covers articles on neonatal lung disease, pulmonary physiology, and respiratory infection.Word count: 71 3

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