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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
PubMed
Summary
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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.

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  • 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.