Pulmonary tuberculosis - virtual bronchoscopy

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

Chest pain, cough, dyspnea & fever.

Patient Data

Age: 25 year old
Gender: Female

Focal luminal narrowing of the left main bronchus.

  • Bilateral upper lung lobar & to less extent lingular multiple confluent patchy areas of air space consolidations showing internal air bronchogram, with adjacent areas of nodular & tree-in bud infiltrates, bronchiectatic changes of the upper lobe segmental bronchi (mainly at the right side) showing peribronchial thickening.
  • Multiple enlarged prevascular, para-tracheal, retrocaval, subcarinal and bilateral hilar lymph nodes.
  • The left hilar lymph nodes encase and extrinsically indenting the middle portion of the left main bronchus which shows mild luminal reduction. 

Case Discussion

The patient had sputum culture which was positive for acid fast bacilli (M. tuberculosis).

Tuberculosis is endemic in Egypt, it has even been found in tissue samples from ancient Egyptian mummies!

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