Tuberculosis presenting as broncho-oesophageal fistula in a young healthy man

BMJ Case Rep. 2017 Jul 31:2017:bcr2017220821. doi: 10.1136/bcr-2017-220821.

Abstract

A 21-year-old Saudi man presented with a history of dysphagia and choking. CT scan of the chest showed clear evidence of chronic recurrent aspiration pneumonia in the left lung. It also showed a fistula connecting the left main bronchus to the oesophagus. Endoscopy showed clear opening on the oesophageal side. Bronchoscopy also confirmed the presence of a broncho-oesophageal fistula on the left bronchial side with the presence of secretions on swallowing. Bronchoalveolar lavage (BAL) was done and sent for mycobacterial tuberculosis culture. The fistula was closed with clips under endoscopic guidance, which alleviated his symptoms of dysphagia and choking. The BAL culture grew mycobacterial tubercle bacilli. The patient showed marked improvement after starting antitubercular therapy and was discharged to be followed up in the clinic.

Keywords: Gi-stents; Tb and other respiratory infections; endoscopy; infection (gastroenterology).

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents / therapeutic use
  • Bronchial Fistula / diagnosis*
  • Bronchial Fistula / diagnostic imaging
  • Bronchial Fistula / etiology
  • Bronchial Fistula / surgery
  • Bronchoalveolar Lavage / methods
  • Bronchoscopy
  • Endoscopy
  • Esophageal Fistula / diagnosis*
  • Esophageal Fistula / diagnostic imaging
  • Esophageal Fistula / etiology
  • Esophageal Fistula / surgery
  • Humans
  • Male
  • Pneumonia, Aspiration / diagnostic imaging
  • Pneumonia, Aspiration / etiology
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Tuberculosis / diagnosis*
  • Tuberculosis / drug therapy
  • Tuberculosis / microbiology
  • Young Adult

Substances

  • Antitubercular Agents