Abstract
Tuberculous infection of the tracheobronchial tree confirmed by microbiological or histopathological evidence with or without parenchymal involvement is known as endobronchial tuberculosis. Chronic cough is the predominant symptom. Expectorated sputum examination for acid fast bacilli is often negative leading to delay in diagnosis. Therefore, bronchoscopy is crucial for early diagnosis and evaluation of the extent of disease. Bronchostenosis is a significant complication of endobronchial tuberculosis that may be present at the time of diagnosis or develops during the course of treatment. Previously, corticosteroids have been used along with antitubercular therapy to prevent or reduce the extent of bronchostenosis; however, their role is debatable as bronchostenosis often develops despite the use of corticosteroids. Furthermore, the duration of treatment varied from 6-9 months of daily therapy in previous series and little is known about efficacy of intermittent antituberculous therapy. Here we report two cases of actively caseating endobronchial tuberculosis successfully managed with six months of intermittent oral antitubercular therapy without corticosteroids.
Highlights
Endobronchial tuberculosis (EBTB) is characterized by tuberculous infection of the tracheobronchial tree that is usually diagnosed by bronchoscopy supplemented with a microbiological or histopathological confirmation
EBTB was found in 4.1% of unselected patients and in 54% of newly diagnosed pulmonary tuberculosis patients undergoing flexible bronchoscopy [3, 4]
EBTB is a special form of tuberculosis mostly affecting people in their second or third decade with an incidence 3-5 times more common in females than males
Summary
Endobronchial tuberculosis (EBTB) is characterized by tuberculous infection of the tracheobronchial tree that is usually diagnosed by bronchoscopy supplemented with a microbiological or histopathological confirmation This can occur with or without parenchymal involvement [1, 2]. We could find two studies reporting a total of 4 cases treated with intermittent antitubercular therapy along with corticosteroids [8, 9]. We report two cases of actively caseating EBTB successfully treated with 6-month intermittent oral antitubercular therapy without corticosteroids. A 24-year-old male presented in February 2015 with breathlessness on exertion for 4 years, productive cough and feverishness lasting for two and half years He had recurrent respiratory symptoms since childhood but denied any treatment for tuberculosis. Manoj Kumar Panigrahi et al, Actively caseating endobronchial tuberculosis successfully treated bacco or drank alcohol He worked in a plywood construction factory in the past four years.
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