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[Phantom thoracic opacity].
A Bakhatar1, A A Yazidi, A el Meziane
1Service des Maladies Respiratoires, CHU Ibn Rochd, Casablanca, Maroc.
Revue Des Maladies Respiratoires
|January 19, 2000
Summary
A rare cause of respiratory distress syndrome is a ruptured tuberculous lymph node. This case highlights the importance of considering tuberculous adenopathy fistulization, even after successful treatment.
Area of Science:
- Pulmonology
- Infectious Diseases
- Critical Care Medicine
Background:
- Respiratory distress syndrome (RDS) is typically caused by pulmonary edema and septic shock.
- Tuberculosis (TB) can affect mediastinal lymph nodes, potentially leading to complications.
- Standard TB treatment involves a multi-drug regimen over several months.
Observation:
- A 24-year-old woman developed RDS two months after completing a 9-month TB treatment.
- Bronchial aspiration revealed pus, and bronchoscopy confirmed a latero-tracheal fistula.
- Initial chest X-ray was normal, with diagnosis suggested by retrospective history.
Findings:
- The patient's RDS was attributed to a ruptured tuberculous latero-tracheal adenopathy forming a ganglio-bronchial fistula.
- Microbiological tests (bacilloscopies and cultures) from bronchial aspirates were negative.
- The patient recovered consciousness by the seventh day of intensive care.
Implications:
- Fistulization of tuberculous adenopathy should be considered in the differential diagnosis of RDS, even in treated patients.
- This rare complication underscores the need for vigilance for late sequelae of TB.
- Prompt diagnosis and management are crucial for favorable outcomes in such cases.