rifampin and Bronchial-Fistula

Bronchoesophageal fistula is a rare complication of Mycobacterium tuberculosis in children. An adolescent girl who was diagnosed of tubercular mediastinal lymphadenopathy with associated bronchoesophageal fistula at presentation, is reported here. This 16-y-old girl presented with high-grade fever, cough, decreased appetite, weight loss for 3 mo, and breathlessness for 10 d. Chest radiograph revealed hilar lymphadenopathy with bilateral pleural effusion. GA GeneXpert was positive for mycobacterium and rifampicin sensitivity. Despite antitubercular therapy cough persisted and there was a history of dry cough with food intake, especially more on liquids. Bronchoscopy and CECT chest confirmed bronchoesophageal fistula in the right main bronchus just below the carina. Child continued on tube feeding and antitubercular therapy. After completion of intensive phase, child improved with resolution of clinical symptoms and scarring of tract on repeat bronchoscopy. It is concluded that in children with combination of mediastinal lymphadenopathy and persistent cough following intake of food needs careful evaluation for trachea/bronchoesophageal fistula.

Topics: Adolescent; Antitubercular Agents; Bronchial Fistula; Child; Cough; Esophageal Fistula; Female; Humans; Lymphadenopathy; Rifampin; Tuberculosis, Lymph Node

A 76-year-old woman was admitted to the hospital four times from November 2007 to June 2009. In this complex case, the patient had silicosis complicated by broncholithiasis, oesophagobronchial fistulas, and relapsed tuberculosis. She had worked as a stone crusher for 3 years and was exposed to a large amount of quartz dust. Barium oesophagography, gastroesophageal endoscopy, and biopsy suggested oesophageal-related chronic inflammation and ulceration, which may have caused the repeated oesophagobronchial fistulas. Bronchoscopy revealed a free broncholithiasis in the left mainstem bronchus. The patient was admitted a fourth time because of silicotuberculosis relapse. After 9 months of antituberculosis treatment, the patient recovered and was still clinically well at the time of this writing.

Topics: Aged; Antibiotics, Antitubercular; Bronchial Fistula; Esophageal Fistula; Esophagoscopy; Female; Humans; Isoniazid; Lithiasis; Pyrazinamide; Rifampin; Silicotuberculosis; Stents; Treatment Outcome

Topics: Anti-Bacterial Agents; Azithromycin; Bronchial Fistula; Cysts; Ethambutol; Humans; Hydropneumothorax; Immunocompromised Host; Liver Diseases; Lung; Lung Diseases; Male; Middle Aged; Mycobacterium avium Complex; Mycobacterium avium-intracellulare Infection; Pleura; Rifampin; Tomography, X-Ray Computed

We report a case of an aortobronchial fistula causing massive hemoptysis, which was managed by emergency stent grafting. Although this procedure was successful initially, the aortobronchial fistula appeared again 7 months later. Aneurysmectomy, followed by rifampicin-soaked gelatin sealed polyester graft replacement and omentopexy, was performed under cardiopulmonary bypass. The patient, a 73-year-old woman, had an uneventful postoperative course and the infection was eradicated.

Topics: Aged; Aneurysm, Infected; Aorta, Thoracic; Aortic Aneurysm, Thoracic; Aortic Rupture; Blood Vessel Prosthesis; Bronchial Fistula; Cardiopulmonary Bypass; Endovascular Procedures; Enzyme Inhibitors; Female; Hemoptysis; Humans; Leprostatic Agents; Prognosis; Rifampin; Stents; Tomography, X-Ray Computed; Vascular Fistula

Topics: Antibiotics, Antitubercular; Bronchial Fistula; Humans; Pleural Diseases; Pneumonia; Radiography; Respiratory Tract Fistula; Rifampin; Tuberculosis, Pulmonary

Two patients with multidrug-resistant pulmonary tuberculosis were surgically treated after 3 and 7 years of unsuccessful chemotherapy. There was pneumonectomy in one case and lobectomy with segmentectomy in the second. Pneumonectomy was complicated by bronchopleural fistula. Both patients become sputum culture negative after surgical treatment but first patient died 5 months after surgery because of acute hepatitis.

Topics: Adult; Antitubercular Agents; Bronchial Fistula; Drug Therapy, Combination; Ethambutol; Fatal Outcome; Humans; Isoniazid; Male; Middle Aged; Pleural Diseases; Pneumonectomy; Pyrazinamide; Rifampin; Sputum; Streptomycin; Tuberculosis, Multidrug-Resistant; Tuberculosis, Pulmonary

Topics: Administration, Oral; Adult; Antifungal Agents; Antitubercular Agents; Aspergillosis; Benzene Derivatives; Bronchial Fistula; Chronic Disease; Female; Humans; Imidazoles; Lung Diseases, Fungal; Pneumothorax; Radiography; Rifampin; Tuberculosis, Pulmonary