[Silicotuberculosis]

Abstract

Objective: Tuberculosis is a serious and common complication of silicosis. The aim of this study is to describe the epidemiological, clinical, radiological and progressive aspects of this pathological entity.

Patients and methods: The study concerns 23 cases of silicotuberculosis which were collected at the service of respiratory diseases at CHU Ibn Rochd of Casablanca, Morocco during 12years (2003-2015).

Results: All patients were men. They were 7 diggers, 5 rock crushers, 7 miners and 4 masons. The mean duration of silica exposure was 11years. The symptomatology was dominated by dyspnea and persistent bronchial syndrome. Imagery showed tumor-like opacities in all cases, associated with mediastinal calcified lymphadenopathy in 9 cases, with micronodules in 8 cases and an excavated opacity in 2 cases. The diagnosis of tuberculosis was confirmed by isolation of the Koch's bacillus in sputum in 13% of cases in the bronchial aspirate in 52% and culture in sputum post-bronchoscopy in 13%. The bronchial biopsies confirmed the diagnosis in 2 cases. Tuberculosis had complicated silicosis 9years on average after the cessation of exposure to silica in 65% of cases. The antituberculous treatment was started in all patients with good clinical outcome in 22 cases. We had deplored a case of death by acute respiratory failure.

Conclusion: Silicosis increases the risk of tuberculosis, hence the importance of TB screening in all patients with silicosis.

Keywords: Bacille de Koch; Bronchoscopie; Bronchoscopy; Exposition à la silice; Exposure to silica; Koch's bacillus; Silicose; Silicosis; Tuberculose; Tuberculosis.