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Fistula Formation between Right Upper Bronchus and Bronchus Intermedius Caused by Endobronchial Tuberculosis: A Case Report.

Kim M, Kang ES, Park JY, Kang HR, Kim JH, Chang Y, Choi KH, Lee KM, Kim Y, An JY - Tuberc Respir Dis (Seoul) (2015)

Bottom Line: Endobronchial tuberculosis is defined as a tuberculous infection of the tracheobronchial tree and has a prevalence of up to 50% in active pulmonary tuberculosis cases.We reported a rare case of a 73-year-old woman with a fistula between the right upper bronchus and bronchus intermedius.The patient was treated with anti-tuberculous medication, and her symptoms gradually improved.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.

ABSTRACT
Endobronchial tuberculosis is defined as a tuberculous infection of the tracheobronchial tree and has a prevalence of up to 50% in active pulmonary tuberculosis cases. The most common complication of endobronchial tuberculosis is bronchial stenosis; benign fistula formation by endobronchial tuberculosis is rare, especially inter-bronchial fistula formation. We reported a rare case of a 73-year-old woman with a fistula between the right upper bronchus and bronchus intermedius. A diagnosis of inter-bronchial fistula caused by endobronchial tuberculosis was based on the results of chest computed tomography scans, bronchoscopy, and microbiological and pathological tests. The patient was treated with anti-tuberculous medication, and her symptoms gradually improved.

No MeSH data available.


Related in: MedlinePlus

(A) Coronal image of the chest obtained using computed tomography (CT) scan revealed multiple variable-sized mediastinal lymph nodes. (B) Sagittal image of chest obtained using CT scan showed the whole pathway of the broncho-bronchial fistula, which originated in the right upper lobe bronchus and inserted in the bronchus intermedius. (C) The volume rendering image showed the presence of a fistula between the right upper lobe bronchus and the bronchus intermedius. RULB: right upper lobe bronchus; BI: bronchus intermedius; RMLB: right middle lobe bronchus.
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Figure 2: (A) Coronal image of the chest obtained using computed tomography (CT) scan revealed multiple variable-sized mediastinal lymph nodes. (B) Sagittal image of chest obtained using CT scan showed the whole pathway of the broncho-bronchial fistula, which originated in the right upper lobe bronchus and inserted in the bronchus intermedius. (C) The volume rendering image showed the presence of a fistula between the right upper lobe bronchus and the bronchus intermedius. RULB: right upper lobe bronchus; BI: bronchus intermedius; RMLB: right middle lobe bronchus.

Mentions: Routine laboratory values were within normal limits, although the patient was anemic, with hemoglobin levels of 10.7 g/dL, and presented with hyponatremia (126 mEq/L), hypoalbuminemia (3.0 g/dL), and elevated C-reactive protein levels (12.26 mg/dL). Three acid-fast bacilli tests of sputum were negative. A chest radiograph showed an ill-defined consolidation in the right lower lung fields and fibrotic change in the right upper lung fields (Figure 1). Computed tomography (CT) scans of the chest showed multiple, ill-defined nodules in the right middle lung and multiple variable-sized mediastinal lymph nodes (Figure 2A). In addition, CT scans of the chest showed an irregular cavity that communicated from the right upper lobe bronchus to the bronchus intermedius (Figure 2B, C). These findings were compatible with an interbronchial fistula.


Fistula Formation between Right Upper Bronchus and Bronchus Intermedius Caused by Endobronchial Tuberculosis: A Case Report.

Kim M, Kang ES, Park JY, Kang HR, Kim JH, Chang Y, Choi KH, Lee KM, Kim Y, An JY - Tuberc Respir Dis (Seoul) (2015)

(A) Coronal image of the chest obtained using computed tomography (CT) scan revealed multiple variable-sized mediastinal lymph nodes. (B) Sagittal image of chest obtained using CT scan showed the whole pathway of the broncho-bronchial fistula, which originated in the right upper lobe bronchus and inserted in the bronchus intermedius. (C) The volume rendering image showed the presence of a fistula between the right upper lobe bronchus and the bronchus intermedius. RULB: right upper lobe bronchus; BI: bronchus intermedius; RMLB: right middle lobe bronchus.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499601&req=5

Figure 2: (A) Coronal image of the chest obtained using computed tomography (CT) scan revealed multiple variable-sized mediastinal lymph nodes. (B) Sagittal image of chest obtained using CT scan showed the whole pathway of the broncho-bronchial fistula, which originated in the right upper lobe bronchus and inserted in the bronchus intermedius. (C) The volume rendering image showed the presence of a fistula between the right upper lobe bronchus and the bronchus intermedius. RULB: right upper lobe bronchus; BI: bronchus intermedius; RMLB: right middle lobe bronchus.
Mentions: Routine laboratory values were within normal limits, although the patient was anemic, with hemoglobin levels of 10.7 g/dL, and presented with hyponatremia (126 mEq/L), hypoalbuminemia (3.0 g/dL), and elevated C-reactive protein levels (12.26 mg/dL). Three acid-fast bacilli tests of sputum were negative. A chest radiograph showed an ill-defined consolidation in the right lower lung fields and fibrotic change in the right upper lung fields (Figure 1). Computed tomography (CT) scans of the chest showed multiple, ill-defined nodules in the right middle lung and multiple variable-sized mediastinal lymph nodes (Figure 2A). In addition, CT scans of the chest showed an irregular cavity that communicated from the right upper lobe bronchus to the bronchus intermedius (Figure 2B, C). These findings were compatible with an interbronchial fistula.

Bottom Line: Endobronchial tuberculosis is defined as a tuberculous infection of the tracheobronchial tree and has a prevalence of up to 50% in active pulmonary tuberculosis cases.We reported a rare case of a 73-year-old woman with a fistula between the right upper bronchus and bronchus intermedius.The patient was treated with anti-tuberculous medication, and her symptoms gradually improved.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.

ABSTRACT
Endobronchial tuberculosis is defined as a tuberculous infection of the tracheobronchial tree and has a prevalence of up to 50% in active pulmonary tuberculosis cases. The most common complication of endobronchial tuberculosis is bronchial stenosis; benign fistula formation by endobronchial tuberculosis is rare, especially inter-bronchial fistula formation. We reported a rare case of a 73-year-old woman with a fistula between the right upper bronchus and bronchus intermedius. A diagnosis of inter-bronchial fistula caused by endobronchial tuberculosis was based on the results of chest computed tomography scans, bronchoscopy, and microbiological and pathological tests. The patient was treated with anti-tuberculous medication, and her symptoms gradually improved.

No MeSH data available.


Related in: MedlinePlus