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Unusual clinical presentation of thoracic tuberculosis: the need for a better knowledge of illness

Manca, Sandra and Fois, Alessandro Giuseppe and Santoru, Luigi and Trisolini, Rocco and Polo, Maria Francesca and Ostera, Salvatore and Patelli, Marco and Pirina, Pietro (2015) Unusual clinical presentation of thoracic tuberculosis: the need for a better knowledge of illness. The American Journal of Case Reports, Vol. 16 , p. 240-244. eISSN 1941-5923. Article.

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DOI: 10.12659/AJCR.892546

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Abstract

Background: Pulmonary tuberculosis (TB), a highly contagious infectious disease, is a significant public health problem all over the world and remains an important cause of preventable death in the adult population. Endobronchial TB is an unusual form of thoracic TB that may be complicated by tracheobronchial stenosis, and bronchoesophageal fistula formation is a very rare complication. Tubercular lymphadenitis can also lead to fistula formation through a process of caseum necrosis and opening of a fistula between the bronchus and oesophagus.
Case Report: We report an uncommon case of thoracic TB in an immunocompetent 73-year-old Caucasian man who presented several problems: bronchoesophageal fistula, endobronchial TB, and mediastinal lymphadenopathy in the absence of contemporary parenchymal consolidation. Furthermore, he presented a normal chest radiograph and mostly unclear and non-specific symptoms at onset.
Conclusions: We emphasize the need for a better knowledge of this illness and awareness that it may have an unusual presentation. In these cases, diagnosis and proper treatment can be delayed, with severe complications for the patient. Pulmonary TB remains a real diagnostic challenge: a normal chest radiograph and nonspecific symptoms do not allow us to exclude this persistent infectious disease.

Item Type:Article
ID Code:10981
Status:Published
Refereed:Yes
Uncontrolled Keywords:Bronchial fistula, tuberculosis, lymph node, tuberculosis, pulmonary
Subjects:Area 06 - Scienze mediche > MED/10 Malattie dell'apparato respiratorio
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Medicina Clinica e Sperimentale
Publisher:International Scientific Literature
eISSN:1941-5923
Deposited On:03 Jun 2015 12:42

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