Seevaunnantum, S. Praveena and Mohd. Ariff @ Ghazali, Nazhan Afeef and Wan Hassan, Wan Mohd Nazaruddin and Muhd Besari, Alwi and Nik Hassan, Nik Fariza Husna and Che Omar, Sanihah and Ali, Saedah and M.Z., Rhendra Hardy and Mat Hassan, Mohd Erham and N.M., Nik Abdullah
(2017)
Case report: Unusual cause of difficulty in intubation and ventilation with asthmatic-like presentation of Endobronchial Tuberculosis.
Respiratory Medicine Case Reports, 22.
pp. 292-294.
ISSN 2213-0071
Abstract
Endobronchial Tuberculosis is hazardous in causing circumferential narrowing of tracheobronchial tree despite
the eradication of tubercle bacilli in the initial insult from Pulmonary Tuberculosis. They may present as
treatment resistant bronchial asthma and pose challenge to airway management in the acute setting. We present
a 25 year-old lady who was newly diagnosed bronchial asthma with a past history of Pulmonary Tuberculosis
that had completed treatment. She presented with sudden onset of difficulty breathing associated with noisy
breathing for 3 days and hoarseness of voice for 6 months. Due to resistant bronchospasm, attempts were made
to secure the airway which led to unanticipated difficult intubation and ventilation. Subsequent investigations
confirmed the diagnosis of Endobronchial Tuberculosis and patient was managed successfully with anti TB
medication, corticosteroids and multiple sessions of tracheal dilatation for tracheal stenosis. This case highlights
the unusual cause of difficulty in intubation and ventilation due to Endobronchial Tuberculosis, which required
medical and surgical intervention to improve the condition.
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