Title:A Case Report of an Endobronchial Tuberculosis-Challenges in Diagnosis and the Role of High-resolution CT Scans and Bronchoscopic Biopsy
Volume: 20
Issue: 4
Author(s): Doan Le Minh Hanh*
Affiliation:
- Department of Internal Medicine, Pham Ngoc Thach University of Medicine, 02 Duong Quang Trung Street, Ward
12, District 10, Ho Chi Minh City, Viet Nam
Keywords:
Endobronchial tumor, tuberculosis, bronchoscopy, slowly resolving pneumonia, non-resolving pneumonia, consolidation, diabetes.
Abstract:
Introduction: Endobronchial tuberculosis is a challenging disease to diagnose, characterized
by infection of the tracheobronchial tree caused by Mycobacterium Tuberculosis. The clinical
presentation of endobronchial tuberculosis is nonspecific and variable, making it difficult to
identify.
Case Report: This report explores the challenges faced during the diagnosis of endobronchial tuberculosis
by a 63-year-old female patient presented with a chronic cough lasting over two
months. Her chest X-ray revealed an inhomogeneous opacity in the left middle zone, accompanied
by an air-bronchogram. Conventional sputum samples and other tests returned negative results.
A high-resolution chest CT scan was almost complete consolidation in the lingular subsegment.
A comprehensive re-evaluation was recommended in this case due to slow re-solving or
non-resolving pneumonia. The histopathological examination of the biopsy sample revealed granulomatous
inflammation with necrosis and lymphocytic infiltration, strongly indicating bronchial
tuberculosis. The Hain test and MGIT culture confirmed the presence of Mycobacterium tuberculosis.
Conclusion: Diagnosing endobronchial tuberculosis can be challenging due to its nonspecific and
variable clinical presentation. High-resolution CT scans provide valuable insights, but the absence
of typical findings can complicate the diagnosis. Bronchoscopic biopsy proved to be the most reliable
method for diagnosing endobronchial tuberculosis in this case. Early and accurate diagnosis
is crucial for initiating appropriate treatment and preventing complications.
