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. 2015 Apr;20(3):488-95.
doi: 10.1111/resp.12474. Epub 2015 Jan 26.

Incidence and clinical predictors of endobronchial tuberculosis in patients with pulmonary tuberculosis

Sung-Soo Jung  1 , Hee-Sun Park, Ju-Ock Kim, Sun-Young Kim
Affiliations

Incidence and clinical predictors of endobronchial tuberculosis in patients with pulmonary tuberculosis

Sung-Soo Jung et al. Respirology. 2015 Apr.

Abstract

Background and objective: Incidence and predictors of endobronchial tuberculosis (EBTB) remain unknown because of the lack of prospective studies. Our objective was to assess the incidence and predictors of concomitant EBTB in patients with active pulmonary tuberculosis (PTB).

Methods: We prospectively performed routine bronchoscopic examination in all patients with PTB to detect EBTB. Clinical and bronchoscopic findings were analyzed to elucidate predictors of EBTB.

Results: Bronchoscopies of 429 PTB patients were performed at a tertiary referral hospital in Korea. Among those, 233 patients (54.3%) had EBTB. Female gender (odds ratio (OR) 4.35, 95% confidence interval (CI) 1.78-10.63), longer symptom duration (>4 weeks; OR 1.86, 95% CI 1.05-5.46), and no previous history of tuberculosis (OR 4.16, 95% CI 1.22-14.18) were found to be the independent predictors of concomitant EBTB in patients with active PTB. Most of the EBTB/PTB patients had mild stenosis, and more than 20% of them had severe stenosis at the time of diagnosis. Patients with EBTB had follow-up bronchoscopy to evaluate persistent airway stenosis. Persistent bronchostenosis with the lumen narrowed by more than one third occurred in 20.7% (30/145) of patients. The involvement length and decreased forced expiratory volume in 1 s were the risk factors for persistent bronchostenosis.

Conclusions: In patients with active PTB, 50% or more have EBTB. Female gender and longer duration of symptoms are the main predictors of concomitant EBTB. Immediate diagnostic bronchoscopy in patients with active PTB should be considered in selected patients for detection of brocnhostenosis.

Keywords: bronchoscopy; bronchostenosis; endobronchial tuberculosis; incidence; predictor.

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Figures

Figure 1
Figure 1
Flow chart of the routine observational bronchoscopy in patients with pulmonary tuberculosis: a total of 528 patients were diagnosed as active pulmonary tuberculosis. Among them, 429 patients were enrolled, and bronchoscopy was performed. EBTB, endobronchial tuberculosis.
See this image and copyright information in PMC

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