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Revista Portuguesa de Pneumologia
Article . 2004
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Tuberculose endobrônquica â alterações clínicas e broncoscópicas

Authors: Maria Sucena; Adelina Amorim; Augusta Machado; Venceslau Hespanhol; Adriana Magalhães;

Tuberculose endobrônquica â alterações clínicas e broncoscópicas

Abstract

RESUMO: A tuberculose endobrônquica (TEB) é uma complicação grave da tuberculose pulmonar, sendo uma causa major de morbilidade.Com o objectivo de caracterizar os casos de TEB, os autores levaram a cabo um estudo retrospectivo destinado à definição dos aspectos demográficos, clínicos, radiológicos, microbiológicos e boncoscópicos.Entre Janeiro de 1999 e Junho de 2002, foi diagnosticada TEB em 14 doentes, com idades compreendidas entre 20 e 78 anos (39,6±18,1). A percentagem de doentes do sexo masculino foi de 57 %, sendo a tosse o sintoma mais comum. Apenas 5 doentes apresentavam pesquisa de BAAR positiva na expectoração. A infiltração do parênquima pulmonar constituiu o achado radiológico mais frequente (35,7 %). As alterações broncoscópicas mais comuns foram TEB caseosa (n=4), granular (n=3) e tumoral (n=3). O brônquio lobar superior esteve envolvido em 64,3% dos casos. Em 9 doentes as alterações broncoscópicas localizaram-se à esquerda, em 3 à direita e em 2 bilateralmente. A biópsia brônquica mostrou um processo inflamatório granulomatoso em 78,6% dos casos. Todos os doentes tiveram pesquisa de BAAR positiva em exame após cultura do lavado brônquico.Dado que os sintomas de TEB são frequentemente mascarados pelos da tuberculose pulmonar, e as alterações radiológicas são inespecíficas, a broncofibroscopia é mandatória para obtenção do diagnóstico e seguimento da sua evolução.REV PORT PNEUMOL 2004; X (5): 383-391 ABSTRACT: Endobronchial tuberculosis (ET) is a serious complication of pulmonary tuberculosis and is a major cause of morbidity.The aim of our retrospective study was to characterize the clinical, radiological, microbiological and bronchoscopic features of ET.Between January 1999 and June 2002 a total of 14 patients were diagnosed as having ET in our hospital. There were 8 (57%) men and 6 women with a median age of 39.6±18.1 years (range from 20 to 78 years). Cough was the most common complain and it was present in 71.4% of patients. Only 5 patients were sputum smear positive. Five patients (35.7%) had parenchymal infiltration and this was the most common roentgenographic appearance. Forms of ET were classified into subtypes: actively caseating (n=4), granular (n=3), tumorous (n=3), edematoushyperemic (n=2) and ulcerative (n=2). The upper lobes were affected in 9 (64.3%) patients. Nine patients had involvement of the left bronchial tree, 3 of the right and in 2 there were bilateral lesions. The diagnosis could be established in 11 (78.6%) cases by bronchial biopsy. All patients had positive bronchial lavage cultures for acid-fast bacilli.Clinical manifestations and roentgenographic appearance of ET are not specific and so bronchoscopy is mandatory for the prompt diagnosis and follow-up of its evolution.REV PORT PNEUMOL 2004; X (5): 383-391 Palavras-chave: Tuberculose endobrônquica, broncofibroscopia, biópsia brônquica, Key-words: Endobronchial tuberculosis, bronchoscopy, bronchial biopsy

Keywords

Diseases of the respiratory system, RC705-779

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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