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Unusual presentation of more common disease/injury
CASE REPORT
Tuberculosis presenting as broncho-oesophageal fistula in a young healthy man
  1. Ahmed Sayeed1,
  2. Eid Humaid Alqurashi2,
  3. Adnan B Alzanbagi3,
  4. Nabil Abdulwadod Badr Ghaleb1
  1. 1Department of Pulmonology, King Abdullah Medical City, Mecca, Saudi Arabia
  2. 2Department of Pulmonology, King Abdullah Medical City, Mecca, Saudi Arabia
  3. 3Department of Gastroenterology, King Abdullah Medical City, Mecca, Saudi Arabia
  1. Correspondence to Dr Ahmed Sayeed, sayeedheena{at}gmail.com, sayeedmodi{at}yahoo.co.in

Summary

A 21-year-old Saudi man presented with a history of dysphagia and choking. CT scan of the chest showed clear evidence of chronic recurrent aspiration pneumonia in the left lung. It also showed a fistula connecting the left main bronchus to the oesophagus. Endoscopy showed clear opening on the oesophageal side. Bronchoscopy also confirmed the presence of a broncho-oesophageal fistula on the left bronchial side with the presence of secretions on swallowing. Bronchoalveolar lavage (BAL) was done and sent for mycobacterial tuberculosis culture. The fistula was closed with clips under endoscopic guidance, which alleviated his symptoms of dysphagia and choking. The BAL culture grew mycobacterial tubercle bacilli. The patient showed marked improvement after starting antitubercular therapy and was discharged to be followed up in the clinic.

  • endoscopy
  • Tb and other respiratory infections
  • Gi-stents
  • infection (gastroenterology)

https://doi.org/10.1136/bcr-2017-220821

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    Footnotes

    • Contributors AS has contributed in planning, conduct, reporting, conception and design, acquisition of data or analysis and interpretation of data. EHA has contributed in planning, conduct, reporting, conception and design. ABA has contributed in conception and design. NABG has contributed in conception and design.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.