Multiple oesophago-respiratory fistulae: sequelae of pulmonary tuberculosis in retroviral infection.
10.11622/smedj.2013259
- Author:
Soo Fin LOW
;
Chai Soon NGIU
;
Erica Yee HING
;
Norzailin Abu BAKAR
- Publication Type:Case Reports
- MeSH:
Adult;
Diagnosis, Differential;
Esophagus;
physiopathology;
Fistula;
diagnosis;
Humans;
Lung;
pathology;
Male;
Radiography, Thoracic;
Retroviridae;
metabolism;
Tomography, X-Ray Computed;
Trachea;
physiopathology;
Treatment Outcome;
Tuberculosis, Lymph Node;
Tuberculosis, Pulmonary;
complications;
diagnosis
- From:Singapore medical journal
2014;55(7):e104-6
- CountrySingapore
- Language:English
-
Abstract:
Pulmonary tuberculosis (PTB) is a common infectious disease worldwide. However, mediastinal tuberculous lymphadenitis complicated by oesophageal involvement and oesophago-respiratory fistula is now uncommon due to improved anti-tuberculous regimes and better general awareness. The overall incidence of acquired oesophago-respiratory fistula due to infection is low, and therefore, the lesion is not often a frontrunner in differential diagnosis. Still, tuberculous oesophago-respiratory fistulae can potentially occur in patients with retroviral disease, as they tend to have atypical and more virulent manifestations. In this study, we report the case of multiple oesophago-respiratory fistulae in a patient with PTB and retroviral disease, and highlight the computed tomography features of these lesions as an atypical presentation of PTB in retroviral disease. Clinicians should suspect oesophago-respiratory fistulae if patients present with Ono’s sign, and remain particularly vigilant for patients with underlying PTB and retroviral disease, as early diagnosis and treatment could help to reduce mortality.
