Undiagnosed acute phase endobronchial tuberculosis with progression to irreversible tracheobronchial stenosis

Description

This case report highlights the challenges in diagnosing the rare endobronchial tuberculosis (EBTB) during the acute phase. The diagnostic dilemma escalated due to the fact that once airway stenosis has developed, it is irreversible and imposes significant morbidity and mortality.

We present a young Chinese woman in her twenties presented to the emergency department (ED) with noisy breathing and breathlessness. She was diagnosed with probable pulmonary tuberculosis (TB) with positive Mantoux and sputum examination for acid-fast bacilli and was started on anti-TB treatment a month prior. In ED, she was breathless, but the oxygen saturation was 95% under room air with normal vital parameters. Auscultations and chest radiograph were unremarkable. Upper airway assessment by the ear, nose and throat surgeon was normal. High-resolution (HR) CT thorax was performed in view of mild occasional stridor observed in the ward (figure 1). The HRCT revealed airway narrowing with bronchiectasis...

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