Tracheobronchial Tuberculosis Without Lung Involvement

Campos, Jerónimo; Ernst, Glenda; Borsini, Eduardo; Garcia, Artemio; Blasco, Miguel; Bosio, Martín; Salvado, Alejandro

doi:10.14740/jocmr2182w

Cited by 4 publications

(4 citation statements)

References 13 publications

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“… 5 The majority of TBTB cases are secondary to PTB, and some patients with TBTB may not necessarily have lung parenchyma involvement. 6 According to reports, TBTB is observed in 10% to 39% of patients with PTB. 7 , 8 TBTB can result in thickening of the tube wall, narrowing of the tube lumen, bronchial dissemination, bronchiectasis, and may also contribute to airway stenosis.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Pulmonary Tuberculosis with Tracheobronchial Tuberculosis: Propensity Score Matching Analysis

Feng,

Guo,

Luo

et al. 2024

IDR

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Background Pulmonary tuberculosis (PTB) with tracheobronchial tuberculosis (TBTB) can lead to tracheal stenosis and atelectasis, but the specific risk factors are currently unclear. Therefore, the goal of this retrospective study is to address this issue and help with the early diagnosis of TBTB. Methods Please include PTB hospitalized in our hospital from January 2021 to October 2023 in the study. After conducting bronchoscopy examinations, the patients were divided into two groups: the PTB group and the PTB&TBTB group. We used the propensity score matching (PSM) to align the baseline data of the two groups of patients, and then performed multiple logistic regression analysis to identify risk factors. Results 643 patients with PTB were included in the study, 227 of whom (35.30%) were diagnosed with TBTB. A total of 204 pairs of patients were successfully matched using the PSM. After matching, there were no statistically significant differences in basic information between the two groups of patients ( P >0.05). Multivariate logistic regression analysis revealed that disease course ≥ 1 month (OR=1.85, 95% CI: 1.21–2.83), complicated with diabetes (OR=3.00, 95% CI: 1.91–4.70), and concomitant pulmonary cavity (OR=3.46, 95% CI: 2.23–5.36) were risk factors for PTB accompanied by TBTB (all P <0.05). Conclusion After adjusting for various influencing factors using PSM, the analysis demonstrated that disease course ≥ 1 month, complicated with diabetes, and concomitant pulmonary cavity are risk factors for PTB combined with TBTB. This emphasizes the significance of improving screening and implementing early intervention measures.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Pulmonary Tuberculosis with Tracheobronchial Tuberculosis: Propensity Score Matching Analysis

Feng,

Guo,

Luo

et al. 2024

IDR

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“…TBTB is a specific subtype of PTB in which the tuberculous lesions are primarily located in the wall of airway, and are not necessarily accompanied by involvement of pulmonary parenchyma[ 9 , 11 ]. Pathological changes in the airway wall can lead to airway stenosis in up to 90% of TBTB patients, especially in the late stage of disease; this is a major cause of mortality in these patients[ 7 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Key determinants of misdiagnosis of tracheobronchial tuberculosis among senile patients in contemporary clinical practice: A retrospective analysis

Tang¹,

Li²,

Guo³

et al. 2021

WJCC

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BACKGROUND Tracheobronchial tuberculosis (TBTB) is a common subtype of pulmonary tuberculosis. Concomitant diseases often obscure the diagnosis of senile TBTB. AIM To characterize senile patients with TBTB and to identify the potential causes of misdiagnosis. METHODS One hundred twenty patients with senile TBTB who were admitted to the Anhui Chest hospital between May 2017 and May 2019 were retrospectively analyzed. Patients were classified as diagnosed group ( n = 58) and misdiagnosed group ( n = 62). Clinical manifestations, laboratory results, radiographic data, and endoscopic findings were compared between the two groups. RESULTS Patients in the misdiagnosed group were most commonly diagnosed as pulmonary tuberculosis (non-TBTB, 29/62, 46.8%), general pneumonia (9/62, 14.5%), chronic obstructive pulmonary disease (8/62, 12.9%), and tracheobronchial carcinoma (7/62, 11.3%). The time elapsed between disease onset and confirmation of diagnosis was significantly longer in the misdiagnosed group [median (first quartile, third quartile): 6.32 (4.94, 16.02) mo vs 3.73 (2.37, 8.52) mo]. The misdiagnosed group had lower proportion of patients who underwent bronchoscopy [33.87% (21/62) vs 87.93% (51/58)], chest computed tomography (CT) scan [69.35% (43/62) vs 98.28% (57/58)], and those who showed CT signs of tuberculosis [27.91% (12/62) vs 50% (29/58)] as compared to that in the diagnosed group ( P < 0.05). There were no significant between-group differences with respect to age, gender, occupation, clinical manifestations, or prevalence of comorbid chronic diseases ( P > 0.05). CONCLUSION Insufficient or inaccurate radiographic or bronchoscopic assessment was the predominant cause of delayed diagnosis of TBTB. Increased implementation and better interpretation of CT scan and early implementation of bronchoscopy can help reduce misdiagnosis of senile TBTB.

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“…Moreover, 10-20% of cases present with normal chest radiographs [14]. Campos et al [15] reported a patient with a normal chest X-ray whose bronchoscopy showed granular TBTB. The diagnosis of TBTB remains a challenge for clinicians since initially it shows non-specific signs and symptoms.…”

Section: Discussionmentioning

confidence: 99%

A Tracheobronchial Tuberculosis Patient With Diffuse Nodules in the Tracheobronchial Mucosa Observed by Bronchoscopy Misdiagnosed as Lung Infection

Yang¹,

Yan²

2018

Clin Infect Immun

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Tracheobronchial tuberculosis (TBTB) is a special form of pulmonary tuberculosis (TB) whose major feature is the infection of the tracheobronchial tree by Mycobacterium tuberculosis. TBTB is diagnosed on histopathological examination of bronchoscopically obtained specimens showing granulomatous inflammation with caseation necrosis and/or positive acid-fast bacilli culture on the microbiological exam. Before bronchoscopy, TBTB is easily misdiagnosed as other lung diseases. This case presentation reports a patient with stable stage pulmonary tuberculosis (PTB) initially misdiagnosed as lung infection before bronchoscopy. Furthermore, sputum smears do not reveal acid-fast bacilli. After being bronchoscopied, the patient showed diffuse nodules in the tracheobronchial mucosa. Sputum culture by rapid liquid method shows positive Mycobacterium tuberculosis. This case can easily be missed diagnosis. It is necessary that bronchoscopy can be a routine means to screen TBTB among the patients with retreated PTB. One rare case was reported. Bronchoscopy showed the presence of diffuse miliary nodules in the mucosa of bilateral bronchi. Pathological examination revealed caseating necrotic granuloma. Mycobacterium tuberculosis was detected by rapid liquid culture. Our case was extremely difficult to diagnose the TBTB without abnormal chest X-ray or computed tomography manifestations. By regular anti-TB treatment with 9 months course, the patient was finally cured with negative Mycobacterium tuberculosis and almost normal tracheobronchial mucosa.

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Tracheobronchial Tuberculosis Without Lung Involvement

Cited by 4 publications

References 13 publications

Risk Factors for Pulmonary Tuberculosis with Tracheobronchial Tuberculosis: Propensity Score Matching Analysis

Risk Factors for Pulmonary Tuberculosis with Tracheobronchial Tuberculosis: Propensity Score Matching Analysis

Key determinants of misdiagnosis of tracheobronchial tuberculosis among senile patients in contemporary clinical practice: A retrospective analysis

A Tracheobronchial Tuberculosis Patient With Diffuse Nodules in the Tracheobronchial Mucosa Observed by Bronchoscopy Misdiagnosed as Lung Infection

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