Between January-December 2002, we noticed an increase of the severe bronchial tuberculosis (lobar, pulmonary atelectasis) at the young adult at the first treatment).
Out of a total of 7641 patients investigated endoscopically in 2002, we detected 78 cases of bronchial tuberculosis (confirmed hystologically and bacteriologically).Their age was between 18 and 83 years; 53 patients were under 45 years old (45 men and 33 women).
In 39 cases, tuberculosis presented localizations at the level of lobe and segmental bronchis.At 22 patients we have detected severe forms with a subtotal atelectasis of intermediary trunk (5), right main bronchus (11), left main bronchus (3), both atelectasis of right main bronchus (total) and left main bronchus (partial) in 2 cases!For 8 cases, the tuberculosis was extremely severe, with tracheal localizations and at the level of one or both main bronchis.In 4 cases, bronchial tuberculosis coexisted with the laryngeal TBC.At 1 patient we also detected epiglotal tuberculosis.In 2 cases, it was tuberculosis at the level of the resection stumps (lobectomy).Two patients had gangliobronchial fistula.Out of the 30 patients with severe forms (pulmonary atelectasis, tracheal localizations etc.), 16 were between 28 and 39 years old; in 7 cases did not exist radiological aspect suggesting tuberculosis.The cases will be presented with an ample iconography.CONCLUSIONS: Tuberculosis can take extremely serious forms; sometimes there are severe discordances between endoscopical aspects (severe) and those radiological (very little or absent).
The young adult with a chronic cough represents a major indication for fibrobronchoscopy.
R. Ulmeanu, None.