Open AccessEpituberculosis Revisited: Case Report and Review
Author(s) -
Lavina Mirchandani,
Sindhu S Kamath,
Jayalakshami Thelapurath Kutty,
Aparna Iyer
Publication year - 2017
Publication title -
journal of clinical and diagnostic research
Language(s) - English
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/jcdr/2017/28718.10584
Subject(s) - medicine , atelectasis , bronchoscopy , lymph node , perforation , surgery , pneumonia , radiology , airway obstruction , bronchus , airway , lung , pathology , respiratory disease , materials science , punching , metallurgy
Primary pulmonary tuberculosis can involve regional lymph nodes which may resolve spontaneously or on treatment; or they may enlarge causing extrinsic bronchial compression; or cause endobronchial inflammation and ulceration; or a node may erode through the bronchial wall with extrusion of caseous materials into the bronchial tree, causing focal or lobar pneumonia. This erosion is seen radiologically as hilar lymphadenopathy, with atelectasis and consolidation and described as "epituberculosis". It is more common in infants than older children. We hereby describe the case of a 13-year-old child with right hilar lymphadenopathy and right upper lobe consolidation on chest x-ray. We demonstrated by fibreoptic bronchoscopy that this epituberculosis resulted from perforation of a lymph node and discharge of caseous material into the upper lobe bronchus with resultant endobronchial obstruction. Thus a tuberculous ruptured lymph node may lead to clinical and radiological worsening, but this does not indicate development of drug resistance in these patients and they respond well to the same treatment regimen.