Mechanical complication of endobronchial tuberculosis

Area of Science:

• Pulmonology
• Infectious Diseases
• Thoracic Surgery

Background:

• Pulmonary tuberculosis (TB) can lead to significant airway complications.
• Airway stenosis is a rare but serious sequela of treated TB.

Observation:

• A 19-year-old female with left upper lobe TB developed progressive dyspnea, wheezing, and left lung collapse.
• Imaging revealed left mainstem bronchial stenosis, confirmed by bronchoscopy showing inflammation and abnormal cartilage.
• Pulmonary function tests indicated severe airway limitation.

Findings:

• Despite completing nine months of anti-TB therapy and oral steroids, the patient experienced partial restenosis.
• Six serial bronchoscopies with dilatations were required to manage the persistent airway narrowing.
• Ventilation-perfusion scans demonstrated severely reduced function in the left lung.

Implications:

• This case underscores the potential for long-term airway sequelae following pulmonary TB.
• Recurrent bronchoscopic dilatations may be necessary to maintain airway patency in such cases.
• Further research into the management of post-tuberculous airway stenosis is warranted.