Cystic pulmonary tuberculosis: A rare form of an ancient disease

Abstract

Cystic pulmonary tuberculosis is a unique form of pulmonary tuberculosis (PTB) presenting with multiple reversible cysts of the lung. Unlike the other forms, this cystic lung disease can improve with prompt tuberculosis treatments. Here we report the case of a 15-year-old girl who presented with respiratory failure and severe lung damage at hospital admission. We diagnosed her with PTB based on her positive GeneXpert result test. The patient was treated with a standard tuberculosis regimen for 6 months and recovered completely.

Keywords: cystic; rare disease; tuberculosis; tuberculosis cystic lung diseases.

FIGURE 1

(A) The patient's initial HRCT was taken right after admission with multiple bilateral cystic‐like lesions, predominance in the upper lobes and right middle lobes. (B) Patient's chest x‐ray (2 weeks before hospital admission) with diffuse miliary nodules and scattered cystic changes nodules (circle)

FIGURE 2

(A) Chest HRCT taken 1 week after initial treatment. Cystic lesion of upper lobes was markedly increased in size with arrangement suggestive of panacinar emphysema (green arrows, with arrowhead point to centrilobular vessel). Several clustered micronodules and microcystic lesions are seen in the hyperdensity regions of the lower lobes. (B) HRCT films were taken 3 and 4 weeks after initial treatment. The cystic lesion of both upper lobes continued to increase in size, some of which fused together to become bullous emphysema. Cystic lesions of lower lobes also increased in number and size. (C) HRCT films taken before discharge and at re‐examination after discharged 6 months. Most of the bullous has been resolved and lung parenchyma restored to normal.