Publish in this journal
Journal Information
Vol. 54. Num. 1.January 2018
Pages 1-58
Vol. 54. Num. 1.January 2018
Pages 1-58
Clinical Image
DOI: 10.1016/j.arbr.2017.11.003
Tracheobronchial Tuberculosis
Tuberculosis traqueobronquial
Visits
111
Ana Belén Gil Guerra
Corresponding author
anagil.guerra@gmail.com

Corresponding author.
, Esther Gómez San Martín, María Rosa López Pedreira
Servicio de Radiodiagnóstico, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
This item has received
111
Visits
Article information
Full Text
Bibliography
Download PDF
Statistics
Full Text

We report the case of a 28-year-old woman with Crohn's disease treated with adalimumab, azathioprine, and mesalazine. Mantoux and chest X-ray performed before treatment were negative. After 4 months of treatment, she presented with a 3-week history of cough, greenish expectoration, dysphonia, and cervical lymphadenopathy. Chest X-ray showed pulmonary consolidation with a cavitated area in the right upper lobe. On computed tomography (CT) (Fig. 1a), several nodular lesions were also observed on the posterior wall of the trachea (Figs. 1b and c), confirmed and biopsied by bronchoscopy (Fig. 1d). Ziehl-Neelsen staining of histological specimen revealed numerous acid-fast bacilli and growth of Mycobacterium tuberculosis was observed on culture. The diagnosis was pulmonary tuberculosis with tracheobronchial dissemination.

Fig. 1.
(0.15MB).

(a) Chest CT: cavitated lesion in the right upper lobe, associated with peripheral “tree-in-bud” micronodular pattern. (b) Several nodular thickenings are observed in the airway (arrow heads). (c) Virtual bronchoscopy: nodular lesions in the trachea. (d) Bronchoscopy: whitish soft-looking lesions attached to the posterior wall of the trachea.

Delay in detecting tracheobronchial tuberculosis can cause tracheal stenosis, atelectasis, postobstructive pneumonia, hemoptysis, and dyspnea.1,2 It tends to affect the main and upper right bronchi.2 CT is useful for diagnosis, as endobronchial lesions and the degree of stenosis can be evaluated,1,2 whereas the appearance of mucosa on bronchoscopy helps to predict the development of stenosis.2 Antituberculosis therapy can be supplemented with steroids,1 while tracheal stenosis may require endoscopic dilation techniques, or surgery as a last option.1,2

References
[1]
J.S. Prince,D.R. Duhamel,D.L. Levin,J.H. Harrell,P.J. Friedman
Nonneoplastic lesions of the tracheobronchial wall: radiologic findings with bronchoscopic correlation
Radiographics, 22 (2002), pp. 215-230
[2]
W.T. Siow,P. Lee
Tracheobronchial tuberculosis: a clinical review
J Thorac Dis, 9 (2017), pp. 71-77

Please cite this article as: Gil Guerra AB, Gómez San Martín S, López Pedreira MR. Tuberculosis traqueobronquial. Arch Bronconeumol. 2018;54:41.

Copyright © 2017. SEPAR
Idiomas
Archivos de Bronconeumología (English Edition)

Subscribe to our Newsletter

Article options
Tools
Cookies policy
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.