Tracheobronchial involvement in 84 cases of pulmonary tuberculosis

In suspected pulmonary tuberculosis (TB), tracheobronchial examination is required for patients with clinical and radiographic features consistent with tuberculosis disease but with negative sputum for Mycobacterium tuberculosis. We report the endoscopic findings of 84 patients who underwent fibreoptic bronchoscopy in recent years, and whose cultures of biological specimens grew M tuberculosis. Cough (86%) and fever (69%) were the most common symptoms, followed by sputum (67%), dyspnoea (30%) and haemoptysis (27%). Chest radiographic abnormalities were mostly localized (60%) with prevalence in the upper lobes; in two cases chest radiography was normal. Sixty two patients (74%) showed endoscopic abnormalities: 1) mucosal inflammation; 2) submucosal granulomas and polyps; and 3) stenoses. They were localized in 58% of patients and diffuse in 42%. Five patients were checked several times during the year following the diagnosis because of a high degree of tracheobronchial involvement. Only one subject recovered, whilst in the other four stenotic sequelae were found. Fibreoptic bronchoscopy confirmed its usefulness in the diagnosis of tuberculosis and in monitoring the course and the outcome of the bronchial tuberculosis involvement.