Congenital Bronchoesophageal Fistula in the Adult

Abstract

ESOPHAGEAL - RESPIRATORY tract fistula with esophageal atresia in the infant usually necessitates immediate diagnostic and therapeutic action. Fistulas without atresia often have an insidious clinical course that occasionally persists into adult life. This uncommon cause of chronic pulmonary sepsis needs reemphasis. A recent case prompts this report and an updated review of the literature. Report of a Case A 58-year-old man was admitted to Philadelphia General Hospital in August 1975, with complaints of anorexia, night-sweats without fever, cough, hemoptysis, and weakness in both lower extremities. His past history included chronic alcoholism and a presumptive diagnosis of pulmonary tuberculosis based on positive PPD tuberculin test results and an abnormal infiltrate in the right middle lobe. Sputum cultures were negative for acid-fast bacilli. In 1972, he was treated for three months with isoniazid but subsequently failed to return for followup examination. He also told of numerous unsubstantiated episodes of pneumonia many years