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Drug-Resistant Bronchial Tuberculosis

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Diagnostic Imaging of Drug Resistant Pulmonary Tuberculosis

Abstract

Tracheobronchial tuberculosis (TBTB), defined as a tuberculosis occurring at mucosa, submucosa, smooth muscle, cartilage, and/or adventitia of trachea or bronchi [1], is one type of pulmonary tuberculosis. About 10–40% of pulmonary tuberculosis patients are complicated with tracheobronchial tuberculosis, and its prevalence keeps rising little by little with the gradual application of bronchoscopy during recent years [2]. The absence of specific early clinical manifestations in tracheobronchial tuberculosis results in misdiagnosis and missed diagnosis in many patients. The diagnosis of TBTB relies on bronchoscopy, which is capable of detecting promptly lesions in tracheobronchial lumen, such as intimal congestion, purulent secretion, swelling, membranous matter and granuloma, and the most characteristic microscopic finding is white or milky caseous substances covering diffusely bronchial mucosa [3]. TBTB can be categorized into six types based on findings under tracheoscopy: inflammatory infiltration (type I), ulcerative necrosis (type II), granulation proliferation (type III), cicatricial stenosis (type IV), softening of tracheobronchial wall (type V), and lymph node fistula (type VI) [1]. Bronchoscopic brush biopsy, having increased significantly the positiveness rate of acid fast bacilli in bronchial tuberculosis patients, provides a basis for pathogenic diagnosis. In addition, imaging examination is the first option for examining bronchial tuberculosis, and CT scans when used to examine bronchial tuberculosis may define not only the location of bronchial lesions, but also the situation of bronchial lumen, such as obstruction or stenosis and atelectasis. Bronchial stenosis, interruption, and deformation shown by chest CT scans are evidences supporting the diagnosis of bronchial tuberculosis. Main modalities for treating tracheobronchial tuberculosis are anti-tuberculosis medications, and the cure rate in treated patients is about 75% with an amelioration rate of about 24% [4].

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Correspondence to Guan-qiao Jin .

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Jin, Gq., Wei, Fj., Luo, Jq., Lu, PX., Lu, Hz., Wang, Y.X.J. (2023). Drug-Resistant Bronchial Tuberculosis. In: Lu, PX., Lu, Hz., Yi, Yx. (eds) Diagnostic Imaging of Drug Resistant Pulmonary Tuberculosis. Springer, Singapore. https://doi.org/10.1007/978-981-99-8339-1_9

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  • DOI: https://doi.org/10.1007/978-981-99-8339-1_9

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-99-8338-4

  • Online ISBN: 978-981-99-8339-1

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