Sepsis syndrome induced by tuberculous perforation of the esophagus

Perforation of the esophagus induced by tuberculosis with no evidence of HIV infection is an extremely unusual presentation of the disease. We report on a 41-year-old man presenting with an esophageal perforation who developed a sepsis syndrome characterized by multiple organ dysfunction. The perforation was covered endoscopically with a tube, the patient recovered from cardiovascular, renal and pulmonary dysfunction under intensive care treatment, including antimycobacterial therapy. In response to endoscopic and medical treatment the size of the lesion decreased and disappeared 56 days after diagnosis. The patient could be discharged 2 months after admission and remained asymptomatic after a 12 month follow-up examination.