Abstract
A 74-year-old man complaining of nonproductive cough and wheeze had been treated with inhaled corticosteroid in diagnosis of bronchial asthma for 7 months. He was referred to our hospital because his symptoms continued and the tracheal stenosis was detected.CT scans on admission showed the stenosis of trachea, and thickened bronchial walls and several nodular lesions in the right upper lobe. A bronchoscopic examination showed the stenosis in the middle portion of trachea with edema and congestion of the mucosa. The ulceration with white coat of the mucosa was observed in the left main bronchus. Mycobacterium tuberculosis was detected on a bronchial lavage fluid and he was diagnosed to have endobronchial tuberculosis. Antituberculosis treatment with isoniazid, rifampicin, ethambutol and pyrazinamide was started. Symptoms improved soon by antituberculosis treatment. A bronchoscopic examination conducted at 6 months later, the stenosis of trachea still remained, but edema and congestion have improved. The ulceration with white coat have improved leaving scar.In the case of bronchial asthma refractory to the adequate treatment, we have to consider the possibility of endobronchial tuberculosis.
