1991 Volume 66 Issue 8 Pages 511-516
A total of 36 patients (16 male and 20 female) with tracheobronchial tuberculosis were admitted during the last nine years and were evaluated for their clinical features.
The chief complaint in three quarters of the patients was intractable cough, in particular, in those with tracheal tuberculosis. One of three patients who suffered from wheezing was prescribed steroid, being diagnosed as having bronchial asthma instead of tuberculosis.
Plain chest X-rays of two patients revealed no abnormality. Pleural effusion was observed in three patients, and miliary tuberculosis in two patients.
Bronchial biopsy was carried out in 23 patients, however, in only 11 patients a histopatho logical diagnosis of tracheobronchial tuberculosis could be made. In contrast, in all 36 patients smear and/or culture for tubercle bacilli were positive. Therefore, bronchial biopsy was considered not to be essential in making a definite diagnosis of bronchial tuberculosis, although it did not exacerbate the lesion to lead to endobronchial stenosis.
Only seven out of 36 patients were in the habit of smoking but three of the four had already broken the habit at least one year before being diagnosed as having the disease. The remaining four patients were still smoking but less than 10 cigaretts a day, with one exceptional patient who was smoking 30 cigarettes on average a day. It has been well known that there is a sexual difference in the incidence of bronchial tuberculosis, namely among females with relatively low population of smokers, the incidence is high. Another probable reason for the higher female incidence is assumed to be due to the structural susceptibility of the bronchus with smaller diameter lumen. Furthermore, it has been found that more than 4, 000 chemical compounds are contained in cigarette smoke. Some of them might act to inhibit the multiplication of tubercle bacilli, leading to the low incidence of the disease in smokers. Our other experiments revealed that tar in cigarette smoke inhibited the multiplication of tubercle bacilli.
Further detailed observation is needed to clarify the possible inhibitory effect of smoking on the development of bronchial tuberclosis.
