Abstract
IntroductionEsophageal involvement by Mycobacterium tuberculosis is rare and the diagnosis is frequently made by means of an esophageal biopsy during the evaluation of dysphagia. There are few cases reported in the literature.Case presentationWe present two cases of esophageal tuberculosis in 85- and 65-year-old male Caucasian patients with initial complaints of dysphagia and epigastric pain. Upper gastrointestinal endoscopy resulted in the diagnosis of esophageal tuberculosis following the biopsy of lesions of irregular mucosa in one case and a sessile polyp in the other. Pulmonary tuberculosis was detected in one patient. In one patient esophageal stricture developed as a complication. Antituberculous therapy was curative in both patients.ConclusionAlthough rare, esophageal tuberculosis has to be kept in mind in the differential diagnosis of dysphagia. Pulmonary involvement has important implications for contact screening.
Highlights
Esophageal involvement by Mycobacterium tuberculosis is rare and the diagnosis is frequently made by means of an esophageal biopsy during the evaluation of dysphagia
Conclusion: rare, esophageal tuberculosis has to be kept in mind in the differential diagnosis of dysphagia
We present two case reports of esophageal involvement by Mycobacterium tuberculosis infection in immunocompetent persons
Summary
Tuberculosis of the esophagus is a rare condition, even in countries with a high incidence of tuberculosis (TB) [1,2], and studies estimate that it constitutes about 0.3% of gastrointestinal TB cases [3]. The persistence of dysphagia to solids led to upper gastrointestinal endoscopy repetition three months after starting antituberculous treatment, and revealed cicatricial stenosis of his esophagus requiring repeated esophageal dilatations (Figure 2). He completed treatment with two months of isoniazid, rifampicin, pyrazinamide and ethambutol, followed by four additional months of rifampicin and isoniazid. Examination performed at that time revealed a right pleural effusion that resolved spontaneously over six months of follow-up, with no etiological diagnosis made He presented with epigastric and left upper abdominal quadrant pain and had an erythrocyte sedimentation rate of 15 mm and a C-reactive protein level of 5.8 mg/ dL (normal range: < 0.5 mg/dL).
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