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Atypical presentation of acquired tracheo-oesophageal fistula in an adolescent girl with pulmonary tuberculosis

We report a case of an adolescent girl presenting with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. Initial presentation during the ongoing COVID-19 pandemic was compatible with multisystem inflammatory response in children associated with COVID-19 (MIS-C). Subsequent...

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Autores principales: Khan, Afreen, Chakravarty, Aparna, Naqishbandi, Rizwan, Qamar, Sumbul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886356/
https://www.ncbi.nlm.nih.gov/pubmed/35228211
http://dx.doi.org/10.1136/bcr-2021-242384
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author Khan, Afreen
Chakravarty, Aparna
Naqishbandi, Rizwan
Qamar, Sumbul
author_facet Khan, Afreen
Chakravarty, Aparna
Naqishbandi, Rizwan
Qamar, Sumbul
author_sort Khan, Afreen
collection PubMed
description We report a case of an adolescent girl presenting with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. Initial presentation during the ongoing COVID-19 pandemic was compatible with multisystem inflammatory response in children associated with COVID-19 (MIS-C). Subsequently a diagnosis of tuberculosis was made. During ventilation, she developed significant abdominal distension which was not relieved with nasogastric decompression. There was a high index of suspicion of bronchoenteric fistula. Bronchoscopy with adjunct oesophagoscopy demonstrated tracheo-oesophageal fistula (TEF). The classical presentation of TEF has been masked by onset of ARDS. During the pandemic the diagnosis of tuberculosis in high-burden countries decreased for multiple reasons leading to development of complications which are often confused with MIS-C. While diagnosing MIS-C, maintaining a high level of suspicion for concomitant or alternative aetiologies is essential.
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spelling pubmed-88863562022-03-17 Atypical presentation of acquired tracheo-oesophageal fistula in an adolescent girl with pulmonary tuberculosis Khan, Afreen Chakravarty, Aparna Naqishbandi, Rizwan Qamar, Sumbul BMJ Case Rep Case Reports: Unusual association of diseases/symptoms We report a case of an adolescent girl presenting with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. Initial presentation during the ongoing COVID-19 pandemic was compatible with multisystem inflammatory response in children associated with COVID-19 (MIS-C). Subsequently a diagnosis of tuberculosis was made. During ventilation, she developed significant abdominal distension which was not relieved with nasogastric decompression. There was a high index of suspicion of bronchoenteric fistula. Bronchoscopy with adjunct oesophagoscopy demonstrated tracheo-oesophageal fistula (TEF). The classical presentation of TEF has been masked by onset of ARDS. During the pandemic the diagnosis of tuberculosis in high-burden countries decreased for multiple reasons leading to development of complications which are often confused with MIS-C. While diagnosing MIS-C, maintaining a high level of suspicion for concomitant or alternative aetiologies is essential. BMJ Publishing Group 2022-02-28 /pmc/articles/PMC8886356/ /pubmed/35228211 http://dx.doi.org/10.1136/bcr-2021-242384 Text en © BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.
spellingShingle Case Reports: Unusual association of diseases/symptoms
Khan, Afreen
Chakravarty, Aparna
Naqishbandi, Rizwan
Qamar, Sumbul
Atypical presentation of acquired tracheo-oesophageal fistula in an adolescent girl with pulmonary tuberculosis
title Atypical presentation of acquired tracheo-oesophageal fistula in an adolescent girl with pulmonary tuberculosis
title_full Atypical presentation of acquired tracheo-oesophageal fistula in an adolescent girl with pulmonary tuberculosis
title_fullStr Atypical presentation of acquired tracheo-oesophageal fistula in an adolescent girl with pulmonary tuberculosis
title_full_unstemmed Atypical presentation of acquired tracheo-oesophageal fistula in an adolescent girl with pulmonary tuberculosis
title_short Atypical presentation of acquired tracheo-oesophageal fistula in an adolescent girl with pulmonary tuberculosis
title_sort atypical presentation of acquired tracheo-oesophageal fistula in an adolescent girl with pulmonary tuberculosis
topic Case Reports: Unusual association of diseases/symptoms
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886356/
https://www.ncbi.nlm.nih.gov/pubmed/35228211
http://dx.doi.org/10.1136/bcr-2021-242384
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