Tuberculosis presenting as bronchoesophageal fistula

Area of Science:

• Pulmonology
• Infectious Diseases
• Gastroenterology

Background:

• Bronchoesophageal fistula is a rare condition, often presenting with complex symptoms.
• Tuberculosis (TB) is a potential, albeit uncommon, cause of bronchoesophageal fistula.
• This case highlights a unique presentation of TB manifesting as a bronchoesophageal fistula.

Purpose of the Study:

• To report a rare case of bronchoesophageal fistula secondary to tuberculosis.
• To describe the diagnostic process and successful management of this condition.
• To emphasize the importance of considering TB in the differential diagnosis of bronchoesophageal fistulas.

Main Methods:

• A case presentation of a 25-year-old female with a 3-month history of cough exacerbated by swallowing.
• Diagnostic workup included radiological examination, bronchoscopy, esophagoscopy, and bronchial biopsy.
• Polymerase chain reaction (PCR) was used to detect Mycobacterium tuberculosis.

Main Results:

• Radiology revealed mediastinal lymphadenopathy.
• Endoscopic procedures confirmed a fistulous communication between the bronchus and esophagus, with signs of endobronchial TB.
• Histology showed non-necrotic granulomas, and PCR confirmed Mycobacterium tuberculosis in bronchial secretions.
• The patient responded well to antitubercular treatment, becoming asymptomatic within 2 months.
• Follow-up bronchoscopy and imaging demonstrated complete resolution of the fistula and lung lesions.

Conclusions:

• Bronchoesophageal fistula can be a rare manifestation of tuberculosis.
• Early diagnosis and appropriate antitubercular therapy are crucial for successful outcomes.
• This case underscores the need for a comprehensive diagnostic approach in patients presenting with symptoms suggestive of bronchoesophageal fistula.