Endobronchial Tuberculosis Simulating Acute Foreign Body Inhalation: A Case Report

Abstract

Endobronchial tuberculosis is a rare form of pulmonary tuberculosis, that can be due to the rupture of an infected lymph node through bronchial wall or lymphatic spread to the lining of the bronchial tree. Clinical presentation is non-specific, and can simulate inhalation of a foreign body. Otolaryngologists should be aware of its presentation often atypical. The following case is an unusual presentation of endobronchial tuberculosis in a 23-month-old patient initially diagnosed as a foreign body in the respiratory tract with acute dyspnea with unilateral wheezing and suspected foreign body on chest computed tomography. Bronchoscopy revealed a granulomatous mass in carina and both primary bronchi. Granuloma ablation improved patient's respiratory status. The pathology revealed an epithelioid and gigantic cellular with caseous necrosis compatible with tuberculosis. This unusual presentation of tuberculosis should be known to otolaryngologists and pediatricians in view of the frequency of tuberculosis in our context as well as increase in its incidence.