Right destroyed lung due to tuberculosis in a Nigerian child: Case report and review of the literature

Abstract

Destroyed Lung Syndrome (DLS) is total lung destruction from recurrent and chronic infections especially Tuberculosis (TB). It is rare in children and associated with chronic morbidity. It presents with chronic cough, progressive difficulty in breathing, hemoptysis and progressive respiratory failure. The pathology of DLS includes lung fibrosis, collapse, tracheal and mediastinal shift. We report the case of a 9 years old girl referred after three courses of anti-TB treatment for suspected TB reinfection with worsening clinical and radiologic features. Investigations revealed a destroyed right lung. Genexpert was initially positive and subsequently along with TB culture was negative. She improved on antibiotics and chest physiotherapy. Destroyed lung though rare in children should be considered in those who despite TB treatment present with worsening clinical and radiologic features. Early diagnosis and multi- disciplinary approach will prevent irreversible lung damage.