Investigation of endobronchial tuberculosis diagnoses in 22 cases
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July 26, 2010 Eur J Med Res (2010) 15: 309-313
309 © I. Holzapfel Publishers 2010
InvEstIgatIon of EndobRoncHIal tubERculosIs dIagnosEs In 22 casEs X. Qingliang, W. Jianxin the Respiratory diseases department of the chinese Pla general Hospital, beijing, china
Abstract Background: Endobronchial tuberculosis (Ebtb) is a special form of pulmonary tuberculosis. In spite of much progress in the diagnosis of this disease in past years, delayed or mistaken diagnosis is still commonly seen. Objective: the aim of this study is to try to find out some useful clues for the diagnosis of Ebtb, especially the early diagnosis. Methods: the medical records of patients with Ebtb were analyzed retrospectively. Results: the male-to-female ratio was 1 : 2.2 out of 22 patients. Patients aged below 60-years-old constituted 72.7% of the cases. 22.7% of these patients were smokers. the male-to-female ratio of smokers was 4:1. 68.2% of these patients tested all showed negative result for the HIv test. the frequent complaints were cough, sputum, shortness of breath and fever, and antibiotic treatments were usually inefficacious. Multiple lobes lesion, exudative shadow and atelectasis were the frequent radiological findings. acid-fast bacilli staining for sputum smear was positive in only 13.6% of these patients. tuberculin skin test was positive in 59.1% of these patients. granular lesion was the most common bronchoscopic appearance in these patients. Histological changes showed distinctive tuberculose lesion in 72.2% of 18 patients undergoing bronchoscopic biopsy. Conclusion: the diagnosis of Ebtb is easily delayed or mistaken because of nonspecific clinical manifestations and the low incidence of positive acid-fast bacilli staining. a high index of awareness of this disease is required for diagnosis. bronchoscopy should be performed as soon as possible in suspected patients, especially when patients present positive tuberculin skin test or no response to antibiotic treatments. Key words: endobronchial tuberculosis; diagnosis
IntRoductIon Pulmonary tuberculosis is one of the major health problems worldwide [1]. In spite of much progress in diagnosis and therapy, this problem still remains. Moreover, there has been a resurgence of pulmonary tuberculosis recently, which is related to the HIv epidemic, multidrug-resistant strains, poverty, immigration, and shortness in the prevention and treatment system [2-4]. Endobronchial tuberculosis (Ebtb) is a special form of pulmonary tuberculosis. about 10%
to 40% of patients with active pulmonary tuberculosis had Ebtb as reported in previous studies [5, 6]. the diagnosis of typical pulmonary tuberculosis is easily confirmed by bacteriological means and radiological findings. However, the diagnosis of Ebtb is more difficult because of variable clinical manifestations. one reason of Ebtb assuming importance is the diagnosis is easily delayed and mistaken. the other is Ebtb may cause a long term sequelae of bronchostenosis. the bronchostenosis is mainly determined by the extent of disease progress
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