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Case Reports
. 2021 Sep 3;14(9):e242907.
doi: 10.1136/bcr-2021-242907.

Oesophagomediastinal fistula: a rare complication of tuberculosis

Maurizio Nedkov Gambin  1 , Sarah Marie Vella  2 , Chantal Vella  2 , John Schembri  2
Affiliations
Case Reports

Oesophagomediastinal fistula: a rare complication of tuberculosis

Maurizio Nedkov Gambin et al. BMJ Case Rep. .

Abstract

We report a case of a woman from Thailand, living in Malta, who was diagnosed with concomitant tuberculosis (TB) and HIV with depleted CD4 count. Her case was further complicated by the formation of a fistula between the mediastinal lymph nodes and the oesophagus, an unusual finding but for which she had many risk factors. The diagnosis was suspected on CT scan of the thorax and confirmed via upper gastrointestinal endoscopy. Following the commencement of both anti-TB and antiretroviral therapy, she suffered a lapse of immune reconstitution inflammatory syndrome but with aggressive medical management eventually made a full recovery without the need for surgical intervention.

Keywords: HIV / AIDS; TB and other respiratory infections; oesophagus.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
CT thorax showing subcarinal lymphadenopathy (white arrow).
Figure 2
Figure 2
CT thorax showing the oesophagus (a) and the oesophagomediastinal fistula (b).
Figure 3
Figure 3
There is a horseshoe-shaped defect and caseous material seen at the fistulous opening.
Figure 4
Figure 4
CT thorax showing resolution of mediastinal lymphadenopathy and oesophagomediastinal fistula.
See this image and copyright information in PMC

References

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