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Multidrug resistant lymph node fistula tracheobronchial tuberculosis: A case report
Jiang Liu1, Shouning Xie2, Laishun Yu3
1Graduate School of Qinghai University.
Medicine
|December 6, 2019
Summary
This case report details a rare instance of multidrug-resistant tracheobronchial tuberculosis with a lymph node fistula. Successful treatment involved a combination of advanced drugs and bronchoscopic interventions, highlighting new therapeutic avenues.
Area of Science:
- Medical Case Reports
- Pulmonology
- Infectious Diseases
Background:
- Tracheobronchial tuberculosis (TBTB) with lymph node fistula is a rare condition.
- Multidrug resistance (MDR) complicates TBTB treatment, necessitating novel therapeutic strategies.
- This case report addresses a unique instance of MDR TBTB with a lymph node fistula, a condition with limited documented cases.
Observation:
- A 15-year-old Tibetan girl presented with persistent TBTB and poor treatment outcomes.
- Initial treatments for TBTB were ineffective, suggesting multidrug resistance.
- The patient developed a lymph node fistula complicating the TBTB.
Findings:
- The patient received a combination of antituberculosis drugs including pyrazinamide, moxifloxacin, protionamide, pasiniazide, and capreomycin.
- Treatment included an 8-month intensive phase and a 12-month consolidation phase.
- Bronchoscopic local injection combined with cryotherapy was performed.
- Post-treatment, bronchoscopy confirmed fistula closure, Mycobacterium cultures were negative, and thoracic CT showed resolution of bronchial stenosis.
Implications:
- This case underscores the importance of considering drug resistance in TBTB and performing drug sensitivity tests.
- Accurate classification of TBTB through bronchoscopy is crucial for tailoring effective treatment strategies.
- The successful management of this complex case offers insights into treating resistant TBTB with fistula formation.
