Endobronchial Tuberculosis : Clinical and Bronchofiberscopic Features

The clinical and bronchofiberscopic features of endobronchial tuberculosis in 53 patients were investigated. These patients comprised 4.7% of some 1,132 subjects who had undergone flexible bronchofiberscopic examinations. The peak incidence occurred in the third and fourth decades, a secondary peak appeared in the seventh decade, a five to six times higher incidence was noted in the female than in the male. Staining for acid-fast bacilli was positive in 67.9% of the patients sputums and or specimens of bronchial washings. A barking cough was the most common chief complaint. Next in order were chest pain, production of mucus, dyspnea, hemoptysis, and fever. Twenty-three out of 53 patients showed abnormalities on their chest films. The flexible bronchoscope revealed tuberculous lesions characterized by mucosal swelling or edema, redness, erosion, ulceration, hypertrophy with luminal narrowing, and cicartical stenosis due to whitish pseudomembrane. The left lower and upper bronchi were involved most frequently. The majority of the patients who were suffering from a barking cough were resistant to antitussive agents but were responsive to steroid combination chemotherapy with antituberculous drugs. In conclusion, the bronchofiberscopic approach is not only helpful in the differentiation of endobronchial tuberculosis from bronchogenic cancer but it can also be used for relieving atelectasis.