[Phantom thoracic opacity].
The etiology of the respiratory distress syndrome is dominated by pulmonary edema and the septic shock. We report a rare etiology of a respiratory distress secondary to a rupture of a well treated tuberculous latero-tracheal adenopathy. A 24-year-old woman was treated a year ago for a peripheral and mediastinal lymph node tuberculosis confirmed by the biopsy of a left supra clavicular adenopathy, by two months of isoniazid-rifampicin-pyrazinamide-ethambutol and seven months of isoniazid-rifampicin. The patient completed 9 month treatment with a good clinical and radiology course. Two months after stopping the antibacillary treatment, the patient was admitted to an intensive care unit with a respiratory distress syndrome requiring both intubation and artificial ventilation. The bronchial aspiration brought back plain pus. The telethorax from admission was normal and the retrospective history suggested the diagnostic of a ganglio-bronchial fistula which was confirmed by bronchial fibroscopy demonstrating right latero-tracheal fistula. The course was good with recovery of consciousness on the seventh day. Direct bacilloscopies and culture were negative. The digestive fibroscopy was normal. Finally, fistulization of a tuberculous adenopathy must be considered among the etiologies of respiratory distress even in a patient appropriately treated for mediastinal lymph node tuberculosis.
Bakhatar
A
A
Service des Maladies Respiratoires, CHU Ibn Rochd, Casablanca, Maroc.
Yazidi
A A
AA
el Meziane
A
A
Bartal
M
M
Benslama
A
A
Moutaouakkil
S
S
D000208:Acute Disease; D000328:Adult; D001983:Bronchial Fistula / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005402:Fistula / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D008206:Lymphatic Diseases / Q000175:diagnosis* / Q000209:etiology; D013902:Radiography, Thoracic; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology*; D014388:Tuberculosis, Lymph Node / Q000150:complications*