Tuberculosis presenting as bronchoesophageal fistula

We report a case of bronchoesophageal fistula associated with tuberculosis. A 25 year old woman presented to us with 3 month history of cough worsening with deglutition. Radiological examination revealed mediastinal lymphadenopathy and bronchoscopy with esophagoscopy confirmed the presence of fistulous communication with features of endobronchial tuberculosis. Histological examination of bronchial biopsy specimen showed non necrotic granuloma with the PCR positive for Mycobacterium tuberculosis in her bronchial secretions. She was begun on antituberculous treatment and became asymptomatic after 2 months. Bronchoscopy done during follow up after 4 months showed normal bronchial lumen with disappearance of fistulous tract. Imaging showed resolution of lung lesions.