Serial fiberoptic bronchoscopic observations of endobronchial tuberculosis before and early after antituberculosis chemotherapy

Abstract

Study objective: To evaluate the antituberculous treatment responsiveness of endobronchial tuberculosis in the different stages of evolution.

Design: A prospective study before and after trial with 9 months of antituberculosis chemotherapy without steroid.

Patients and intervention: One hundred thirty-six endobronchial lesions in 62 patients were subdivided into four types according to initial fiberoptic bronchoscopic (FOB) findings. Follow-up FOB was performed in 29 patients with 56 endobronchial lesions to detect the changes in the initial endobronchial lesion and bronchostenosis within 3 months after completion of 9 months of chemotherapy.

Results: The endobronchial lesions could be classified into four types: exudative (59 lesions, 43.3 percent), ulcerative (13 lesions, 9.7 percent), cicatricial (36 lesions, 26.5 percent), and bronchoglandular (28 lesions, 20.5 percent). In the reassessment of 56 lesions, all 19 exudative and all 9 ulcerative lesions showed complete improvement. Of the cicatricial lesions, most (10 of 12 lesions) showed no change in bronchostenosis, whereas 2 lesions showed improvement. In the bronchoglandular lesions, 6 of 18 lesions showed progressed bronchostenosis. Overall, we observed improved responses in 53.6 percent, progressed bronchostenosis in 10.7 percent, and stationary responses in the remaining 35.7 percent. The progressed lesions were found only in the bronchoglandular lesions.

Conclusion: In the exudative, ulcerative, and cicatricial lesions, the administration of antituberculous chemotherapy alone resulted in favorable responses in the early posttreatment period.