Primary esophageal tuberculosis: A case report
DOI:
https://doi.org/10.24265/horizmed.2021.v21n1.14Keywords:
Tuberculosis, Esophagus, Polymerase chain reaction, Mycobacterium, EndoscopyAbstract
A 60-year-old woman born in Tarma and living in Lima, with a history of biomass exposure, contact with a patient with tuberculosis, arterial hypertension, heart arrhythmia and mother with ovarian cancer, visited the medical center with progressive dysphagia, 15-kilogram weight loss and evening fever for seven months. A previous endoscopy revealed an esophageal tumor. A CT scan showed middle and distal third esophageal wall thickening, and 10x10 mm mediastinal adenopathies. The rest of the thoracic and abdominal organs were normal. The last endoscopy revealed an ulcerated lesion in the esophagus. The pathological evaluation showed a large chronic granulomatous inflammation with giant cells and necrosis. Ziehl–Neelsen stain was negative for Koch bacillus and revealed no malignant lesion. A Mycobacterium tuberculosis-positive polymerase chain reaction (PCR) was observed. An adenopathy biopsy was performed by endoscopic ultrasound and PCR outcome was negative for Mycobacterium tuberculosis. In conclusion, primary esophageal tuberculosis was diagnosed and a specific treatment with a weight-adjusted dose was initiated.
Downloads
References
Patel N, Amarapurkar D, Agal S, Baijal R, Kulshrestha P, Pramanik S, et al. Gastrointestinal luminal tuberculosis: establishing the diagnosis. J Gastroenterol Hepatol. 2004; 19(11): 1240-6.
Gupta SP, Arora A, Bhargava DK. An unusual presentation of oesophageal tuberculosis. Tuber Lung Dis. 1992; 73(3): 174-6.
Fahmy AR, Guindi R, Farid A. Tuberculosis of the oesophagus. Thorax. 1969; 24(2): 254-6.
Lockard LB. Esophageal tuberculosis: a critical review. Laryngoscope. 1913; 23(5): 561-84.
Chahud Isse A. Digestive tuberculosis. Rev Gastroenterol Peru. 1991; 11(1): 72-89.
Yriberry S, Cervera Z, Soriano C, Frisancho O, Machado A, Zumaeta E. Tuberculosis digestiva en el Hospital Nacional Edgardo Rebagliati Martins (HNERM): un estudio retrospectivo de 5 años (1993-1998). Rev Gastroenterol Perú. 1998; 18(3): 238-49.
Malca CL, Torreblanca NJ, Asato HC, Velasco ML. Esophageal tuberculosis: case report. Rev Gastroenterol Peru. 2003; 23 (1): 67-9.
Liu FG, Pan JX, Wu GG. CT diagnosis of mediastinal lymphnodein adults. Chin Radiol J. 2001; 35: 655-8.
Kramer P. Infections of the esophagus. En: Gastroenterology. 3rd edition. W. B. Saunders Company LTD; 1974. p. 329-38.
Peixoto PC, Ministro PS, Sadio AD, Cancela EM, Araújo RN, Machado JL, et al. Esophageal tuberculosis: an unusual cause of dysphagia. Gastrointest Endosc. 2009; 69(6): 1173-6.
Vahid B, Huda N, Esmaili A. An unusual case of dysphagia and chest pain in a non-HIV patient: esophageal tuberculosis. Am J Med. 2007; 120(4): e1-2.
O’Leary M, Nollet DJ, Blomberg DJ. Rupture of a tuberculous pseudoaneurysm of the innominate artery into the trachea and esophagus: report of a case and review of the literature. Hum Pathol. 1977; 8(4): 458-67.
Wigley FM, Murray HW, Mann RB, Saba GP, Kashima H, Mann JJ. Unusual manifestation of tuberculosis: TE fistula. Am J Med. 1976; 60(2): 310-4.
Nagi B, Lal A, Kochhar R, Bhasin DK, Gulati M, Suri S, et al. Imaging of esophageal tuberculosis: a review of 23 cases. Acta Radiol. 2003; 44(3): 329-33.
Patnayak R, Reddy MK, Parthasarathy S, Yootla M, Reddy V, Jena A. Unusual presentation of esophageal tuberculosis mimicking malignancy. Saudi J Gastroenterol. 2008; 14(2): 103-4.
Fujiwara Y, Osugi H, Takada N, Takemura M, Lee S, Ueno M, et al. Esophageal tuberculosis presenting with an appearance similar to that of carcinoma of the esophagus. J Gastroenterol. 2003; 38(5): 477-81.
Kang M-J, Yi SY. Esophageal tuberculosis presenting as a submucosal tumor. Clin Gastroenterol Hepatol. 2008; 6(2): A26.
Savage PE, Grundy A. Oesophageal tuberculosis: an unusual cause of dysphagia. Br J Radiol. 1984; 57(684): 1153-5.
Gordon AH, Marshall JB. Esophageal tuberculosis: definitive diagnosis by endoscopy. Am J Gastroenterol. 1990; 85(2): 174-7.
Fujiwara T, Yoshida Y, Yamada S, Kawamata H, Fujimori T, Imawari M. A case of primary esophageal tuberculosis diagnosed by identification of Mycobacteria in paraffin-embedded esophageal biopsy specimens by polymerase chain reaction. J Gastroenterol. 2003; 38(1): 74-8.
Welzel TM, Kawan T, Bohle W, Richter GM, Bosse A, Zoller WG. An unusual cause of dysphagia: esophageal tuberculosis. J Gastrointestin Liver Dis. 2010; 19(3): 321-4.
Bresky RG, Silva ZN, Madariaga GJ. Esofagitis tuberculosa en un paciente HIV positivo. Rev Med Chil. 2007; 135(10): 1323-6.
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Horizonte Médico (Lima)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Horizonte Médico (Lima) (Horiz. Med.) journal’s research outputs are published free of charge and are freely available to download under the open access model, aimed at disseminating works and experiences developed in biomedical and public health areas, both nationally and internationally, and promoting research in the different fields of human medicine. All manuscripts accepted and published in the journal are distributed free of charge under the terms of a Creative Commons license – Attribution 4.0 International (CC BY 4.0).
