PTB airway compression complicated by vascular abnormalities and cardiac involvement: A case series demonstrating diagnosis and management.

Abstract

Lymphobronchial tuberculosis (LBTB) is a tuberculous lymphadenopathy causing airway compression in young children. While it can occur in older children due to factors such as airway size, wall weakness, and immune reconstitutions, severe airway obstruction is more common in younger children. Chest X-rays show airway compression, while bronchoscopy is the gold standard for confirming TB-induced airway compression. Previous research has demonstrated that drug resistance and HIV have no effect on the outcome of children with significant airway compression caused by TB. This case series describes the management and outcome of three young children who had simultaneous vascular abnormalities and airway obstruction due to pulmonary tuberculosis (PTB). Concomitant PTB and vascular abnormalities are uncommon, even in high-TB-intensity areas, and affected children may present differently and require individualised treatment. Advanced imaging is critical for detecting complicated cases of airway compression due to PTB in young children, as vascular abnormalities are uncommon. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) may show metabolically active intracardiac lesions. Individualised management plans are required for these children, and echocardiography is critical for patients with disseminated disease.