Case report: Unusual cause of difficulty in intubation and ventilation with asthmatic-like presentation of Endobronchial Tuberculosis

Respiratory Medicine Case Reports

Sanihah Che Omar¹  N.M. Nik Abdullah¹  Saedah Ali¹  M.Z. Rhendra Hardy¹  S. Praveena Seevaunnamtum¹  Mohd Erham Mat Hassan¹  Nazhan Afeef Mohd. Ariff @ Ghazali¹  Wan Mohd Nazaruddin¹  Alwi Muhd Besari²  N.H. Nik Fariza³ 

[1] Department of Anaesthesiology & Intensive Care, School of Medical Science, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia;Department of Internal Medicine, School of Medical Science, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia;Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Science, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia;

关键词: Endobronchial tuberculosis;    Bronchospasm;    Subglottic stenosis;    Bronchial asthma;   

DOI  :  10.1016/j.rmcr.2017.10.011

来源: DOAJ

【 摘 要 】

Endobronchial Tuberculosis is hazardous in causing circumferential narrowing of tracheobronchial tree despite the eradication of tubercle bacilli in the initial insult from Pulmonary Tuberculosis. They may present as treatment resistant bronchial asthma and pose challenge to airway management in the acute setting. We present a 25 year-old lady who was newly diagnosed bronchial asthma with a past history of Pulmonary Tuberculosis that had completed treatment. She presented with sudden onset of difficulty breathing associated with noisy breathing for 3 days and hoarseness of voice for 6 months. Due to resistant bronchospasm, attempts were made to secure the airway which led to unanticipated difficult intubation and ventilation. Subsequent investigations confirmed the diagnosis of Endobronchial Tuberculosis and patient was managed successfully with anti TB medication, corticosteroids and multiple sessions of tracheal dilatation for tracheal stenosis. This case highlights the unusual cause of difficulty in intubation and ventilation due to Endobronchial Tuberculosis, which required medical and surgical intervention to improve the condition.

【 授权许可】

Unknown