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[Two cases of bronchial tuberculosis--diagnostic difficulties]
Andrzej Krzywiecki1, Roman Rauer, Wojciech Zajecki
1Z Kliniki Ftizjopneumonologii, Zabrze.
Pneumonologia I Alergologia Polska
|August 13, 2004
Summary
This study highlights two bronchial tuberculosis cases. Diagnosis required bronchoscopy and cultures, as sputum smears and Mantoux tests were inconclusive.
Area of Science:
- Pulmonology
- Infectious Diseases
- Microbiology
Background:
- Bronchial tuberculosis is a challenging diagnosis.
- Traditional diagnostic methods like sputum smears and Mantoux tests can be negative.
Observation:
- A 45-year-old male presented with diffuse necrotic changes in bronchoscopy, confirmed as coagulative necrosis histologically.
- A 19-year-old female showed right lung bronchopneumonia with diffuse necrotic infiltration on bronchoscopy.
Findings:
- Acid-fast bacilli (AFB) were detected only in cultures for the first patient.
- Tuberculosis etiology was confirmed by positive bronchial washings (brosage) in the second patient, despite a negative Mantoux reaction.
Implications:
- Bronchoscopy with bronchial washings and cultures are crucial for diagnosing bronchial tuberculosis when other methods fail.
- Negative sputum smears and Mantoux reactions do not rule out bronchial tuberculosis.