A case of multi-drugresistant tuberculosis complicated with bronchoesophageal fistula
Nobuo Hatakeyama1) Yoshio Okano1) Mari Miki2) Yosihito Iwahara1) Yoichi Nakamura2) Tokuji Motoki1) Fumitaka Ogushi1)
Department of Respiratory Medicine1), Clinical Research Center for Allergy and Rheumatology2), National Hospital Organization, Kochi National Hospital
A 71-year-old man visited the surgical department of our hospital due to back pain in November, 1999. Esophagogram showed bronchoesophageal fistula and a plain chest radiograph showed a nodular shadow in the left upper area with left pleural effusion. As the symptom disappeared on treatment with an antimicrobial agent, he was followed up as an outpatient. In August, 2001, he presented to the Respiratory Department of our hospital with low-grade fever and productive cough. Since tubercle bacilli were detected in a sputum culture, combined treatment with antituberculous chemotherapy was started. But, none of the symptoms were improved. These bacilli were identified as being multi-drug-resistant. After the chemotherapy regimen was changed, the symptoms disappeared and the esophagorespiratory fistula was closed. We report a rare case of esophagorespiratory fistula with multi-drug resistant tuberculosis, which was improved by chemotherapy.
Multi-drug resistant tuberculosis Bronchoesophageal fistula Esophagogram
Received 平成15年12月8日
JJRS, 42(8): 755-759, 2004