Clinical features of endobronchial tuberculosis
Abstract
Background/Aim. Endobronchial tuberculosis (EBTB) is a specific type of pulmonary tuberculosis which often affect the tracheobronchial tree, and can be microbiologically and/or pathohistologically confirmed. The aim of the study was to determine the clinical features and diagnostic aspects of EBTB. Methods. This retrospective study was conducted at the Clinic for Lung Diseases, Clinical Center of Serbia, Belgrade, from January 1997 to December 2007. All patients with EBTB confirmed by bronchoscopy with biopsy during a study period were analysed. Data included the patient’s medical history, a physical exam, chest X-ray, mycobacterial analysis of sputum samples, endoscopic types and patohistological confirmation. Results. In the study, 57.6% of the patients were males. The most frequent symptoms were cough (71.2%), malaise (54.2%), fever (49.2%), weight loss (40.7%), and hemoptysis (13.6%). Most of the patients were diagnosed within 30 days of symptoms onset. Sputum examination showed acid-fast bacilli in 31.4% of the patients, while sputum culture for tuberculosis bacilli were positive in 55.9% of the patients. The most common radiographic localization was in the upper lung lobes (63.5%). Cavities were present in 60.4% of the patients. The most common endoscopic subtype determined by bronchoscopy were nonspecific bronchitis (39.9%) and edematous-hyperemic subtype (36.4%). Conclusion. EBTB was more frequent among men, and among people in their fifties in our country. Detailed bronchoscopic examination, correlated with clinical and laboratory findings, will improve diagnostic rate and provide timely therapy.
References
Hoheisel G, Chan BK, Chan CH, Chan KS, Teschler H, Costabel U. Endobronchial tuberculosis: Diagnostic features and therapeu-tic outcome. Respir Med 1994; 88(8): 593 –7.
Kashyap S, Mohaparta PR, Saini V. Endobronchial Tuberculosis. Indian J Chest Dis Allied Sci 2003; 45(4): 2472–6.
Tetikkurt C. Current perspectives on endobronchial tuberculo-sis. Pneumon 2008; 21(3): 239–5.
Chung HS, Lee JH. Bronchoscopic assesment of the evolution of endobronchial tuberculosis. Chest 2000; 117(2): 385– 92.
Kim YH, Kim HT, Lee KS, Uh ST, Cung YT, Park CS. Serial fi-beroptic bronchoscopic observations of endobronchial tuber-culosis before and early after antituberculosis chemotherapy. Chest 1993; 103(3): 673– 7.
Jovanovic D, Skodric-Trifunovic V, Markovic-Denic L, Stevic R, Vlaji-nac H. Clinical and epidemiological evaluation of tuberculosis in Serbia, 1990–2004. Int J Tuberc Lung Dis 2007; 11(6): 647–51.
Pešut DP, Gledovic ZB, Grgurevic AD, Nagorni Obradovic LM, Adzic TN. Tuberculosis incidence in elderly in Serbia: key trends in socioeconomic transition. Croat Med J 2008; 49(6): 807– 12.
Zutić H, Dizdarević Z, Ustamujić A, Hadzimurtezić Z. More than ten years of DOTS in Bosnia and Herzegovina. Bosn J Basic Med Sci 2008; 8(1): 52–7.
Ip MS, So SY, Lam WK, Mok CK. Endobronchial tuberculosis revisited. Chest 1986; 89(5): 727– 30.
Hoheisel G, Chan BK, Chan CH, Chan KS, Teschler H, Costabel U. Endobronchial tuberculosis: diagnostic features and therapeu-tic outcome. Resp Med 1994; 88(8): 593–7.
Wang SY, Zhang XS. Endobronchial tuberculosis. Report of 102 cases. Chest 1994; 105(6): 1910−1.
Kurasawa T, Kuze E, Kawai M, Amitani R, Murayama T, Tanaka E, et al. Diagnosis and management of endobronchial tuber-culosis. Intern Med 1992; 31(5): 593–8.
Morrone N, Abe NS. Bronchoscopic findings in patients with pulmonary tuberculosis. J Bronchol 2007; 14(1): 15–8.
Lee JH, Park SS, Lee DH, Shin DH, Yang SC, Yoo BM. Endo-bronchial tubeculosis. Clinical and bronchoscopic features in 121 cases. Chest 1992; 102(4): 990–4.
Sucena M, Amorim A, Machado A Hespanhol V, Magalhães A. Endobronchial tuberculosis-clinical and bronchoscopic fea-tures. Rev Port Pneumol 2004; 10(5): 383−91.
Cordovilla R, Jimenez-Massa A. Endobronchial tuberculosis. a case report and review of the literature. J Bronchol Intervent Pulmonol 2009; 16(2): 121–3.
Lohani S, Chadwick PR, Armstrong G, O' Driscoll R, Taggart S. Endobronchial Mimics of Lung Cancer. J Bronchol 2005; 121: 56–8.
Kreisel D, Arora N, Weisenberg SA, Saqi A, Krupnick A, De-metriades A, et al. Tuberculosis presenting as an endobronchial mass. J Thorac Cardiovasc Surg 2007; 133(2): 582–4.
Lee JH, Chung HS. Bronchoscopic, radiologic and pulmonary function evaluation of endobronchial tuberculosis. Respirology 2000; 5(4): 411–7.
Golshan M. Tuberculous bronchitis with normal chest x ray among a large bronchoscopic population. Ann Saudi Med 2002; 22(1–2): 98−101.
Berger HW, Granada MG. Lower lung fields tuberculosis. Chest 1974; 65(5): 522–6.
Kim HC, Kim HS, Lee SJ, Jeong YY, Jeon KN, Lee JD, et al. En-dobronchial tuberculosis presenting as right middle lobe syn-droma: clinical characteristics and bronchoscopic findings in 22 cases. Yonsei Med J 2008; 49(4): 615–9.
Lee JH, Park SS, Lee DH, Shin DH, Yang SC, Yoo BM. Endo-bronchial tuberculosis. Clinical and bronchoscopic features in 121 cases. Chest 1992; 102(4): 990−4.
Marković-Denić L, Vlajinac H, Zivković S, Miljus D. Cancer mor-tality among men in Central Serbia: 1985-2006 survey study. Croat Med J 2008; 49(6): 792–8.
Stojsic J, Jovanovic D, Sudjic E. Pathohistological diagnosis of en-dobronchial tuberculosis. Int J Tuberc Lung Dis 2005; 9(Suppl1): 11.
Xue Q, Wang N, Xue X, Wang J. Endobronchial tuberculosis: an overview. Eur J Clin Microbiol Infect Dis 2011; 30(9): 1039– 44.