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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2022
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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. |
format | Online Article Text |
id | pubmed-8886356 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
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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