rifampin and Respiratory-Sounds

We report a case of primary tuberculous tracheitis in an otherwise healthy woman who presented with cough and stridor due to diffuse tracheal narrowing by tuberculous pseudomembranous lesion, which resolved completely with antituberculosis chemotherapy.

Topics: Antitubercular Agents; Cough; Ethambutol; Female; Humans; Isoniazid; Middle Aged; Pyrazinamide; Respiratory Sounds; Rifampin; Tracheal Stenosis; Tracheitis; Tuberculosis, Pulmonary

A three and a half-year-old boy developed stridor after insertion of grommets for bilateral secretory otitis media. Despite treatment with steroids systemically and locally, antibiotics and an antihistamine, the stridor worsened. Microlaryngotracheobronchoscopy (MLB) demonstrated laryngeal granulations, in which, by auramine and Ziehl-Neelsen staining, acid-fast bacilli were seen, and from which subsequently Mycobacterium tuberculosis grew in culture. Following the MLB the child became comatosed and a clinical diagnosis of tuberculosis involving the central nervous system was made. Despite quadruple antituberculous chemotherapy he died 8 days later. A Mantoux test was negative and a chest radiograph was normal. Acid-fast bacilli were not demonstrated on repeated examinations of cerebrospinal fluid, nor were they grown ante mortem or post mortem from samples of cerebrospinal fluid.

Topics: Child, Preschool; Humans; Injections, Intramuscular; Injections, Spinal; Isoniazid; Larynx; Lung; Male; Pyrazinamide; Respiratory Sounds; Rifampin; Streptomycin; Tomography, X-Ray Computed; Tuberculosis, Laryngeal; Tuberculosis, Miliary