Post Covid-19 endobronchial tuberculosis misdiagnosed as asthma
https://doi.org/10.4081/cdr.11.11680
Accepted: 28 September 2023
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
We present a case of a 21-year-old woman, with prolonged cough and wheezing following a mild COVID-19 infection. Despite multiple attempts to recognize the cause and manage her cough, her symptoms did not improve. A careful examination revealed monophonic wheezing and purulent sputum, raising suspicion for Endobronchial Tuberculosis (EBTB). Chest computed tomography scan showed a tree-in-bud pattern and narrowed the bronchial lumen. Acid-fast bacillus smear and genXpert MTB/RIF test further confirmed the presence of Mycobacterium tuberculosis. This case highlights the importance of considering EBTB as a potential diagnosis for chronic cough, particularly in COVID-19 survivors in tuberculosis-endemic areas.
Chamberlain SA, Garrod R, Douiri A, et al. The impact of chronic cough: a cross-sectional European survey. Lung. 2015;193:401-8. DOI: https://doi.org/10.1007/s00408-015-9701-2
Irwin RS, French CL, Chang AB, Altman KW. Classification of Cough as a Symptom in Adults and Management Algorithms: CHEST Guideline and Expert Panel Report. Chest. 2018;153:196-209. DOI: https://doi.org/10.1016/j.chest.2017.10.016
Nguyen-Ho L, Tran-Van N, Le-Thuong V. Central versus peripheral lesion on chest X-Ray: A case series of 31 endobronchial tuberculosis patients with negative sputum smears. Int J Mycobacteriol. 2021;10:89-92. DOI: https://doi.org/10.4103/ijmy.ijmy_216_20
French CL, Irwin RS, Curley FJ, Krikorian CJ. Impact of chronic cough on quality of life. Archives of internal medicine. 1998;158:1657-61. DOI: https://doi.org/10.1001/archinte.158.15.1657
French CL, Crawford SL, Bova C, Irwin RS. Change in Psychological, Physiological, and Situational Factors in Adults After Treatment of Chronic Cough. Chest. 2017;152:547-62. DOI: https://doi.org/10.1016/j.chest.2017.06.024
D'Cruz RF, Waller MD, Perrin F, et al. Chest radiography is a poor predictor of respiratory symptoms and functional impairment in survivors of severe COVID-19 pneumonia. ERJ open research. 2021;7. DOI: https://doi.org/10.1183/23120541.00655-2020
Carfì A, Bernabei R, Landi F. Persistent Symptoms in Patients After Acute COVID-19. Jama. 2020;324:603-5. DOI: https://doi.org/10.1001/jama.2020.12603
Mandal S, Barnett J, Brill SE, et al. 'Long-COVID': a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax. 2021;76:396-8. DOI: https://doi.org/10.1136/thoraxjnl-2020-215818
Song WJ, Hui CKM, Hull JH, et al. Confronting COVID-19-associated cough and the post-COVID syndrome: role of viral neurotropism, neuroinflammation, and neuroimmune responses. The Lancet Respiratory medicine. 2021;9:533-44. DOI: https://doi.org/10.1016/S2213-2600(21)00125-9
Lee JH, Park SS, Lee DH, et al. Endobronchial tuberculosis. Clinical and bronchoscopic features in 121 cases. Chest. 1992;102:990-4. DOI: https://doi.org/10.1378/chest.102.4.990
Ozkaya S, Bilgin S, Findik S, et al. Endobronchial tuberculosis: histopathological subsets and microbiological results. Multidisciplinary respiratory medicine. 2012;7:34. DOI: https://doi.org/10.4081/mrm.2012.621
Yu W, Rong Z. Clinical analysis of 90 cases with endobronchial tuberculosis]. Chinese journal of tuberculosis and respiratory diseases. 1999;22:396-8.
Riou C, du Bruyn E, Stek C, et al. Relationship of SARS-CoV-2-specific CD4 response to COVID-19 severity and impact of HIV-1 and tuberculosis coinfection. The Journal of clinical investigation. 2021;131. DOI: https://doi.org/10.1172/JCI149125
Gopalaswamy R, Subbian S. Corticosteroids for COVID-19 Therapy: Potential Implications on Tuberculosis. International Journal of Molecular Sciences. 2021;22. DOI: https://doi.org/10.3390/ijms22073773
Bagcchi S. WHO's Global Tuberculosis Report 2022. The Lancet Microbe. 2023;4:e20. DOI: https://doi.org/10.1016/S2666-5247(22)00359-7
Nguyen‐Ho L, Nguyen‐Tiet A, Chang YS. Asthma and pulmonary tuberculosis: misdiagnosis or coexistence. Respirol Case Rep. 2021;9:e00797. DOI: https://doi.org/10.1002/rcr2.797
Hatipoğlu ON, Osma E, Manisali M, et al. High resolution computed tomographic findings in pulmonary tuberculosis. Thorax. 1996;51:397-402. DOI: https://doi.org/10.1136/thx.51.4.397
Kashyap S, Solanki A. Challenges in endobronchial tuberculosis: from diagnosis to management. Pulmonary Medicine. 2014;2014:594806. DOI: https://doi.org/10.1155/2014/594806
Altin S, Cikrikçioğlu S, Morgül M, et al. 50 endobronchial tuberculosis cases based on bronchoscopic diagnosis. Respiration; international review of thoracic diseases. 1997;64:162-4. DOI: https://doi.org/10.1159/000196662
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
