Treatment of ulcerative endobronchial tuberculosis and bronchial stenosis with aerosolized streptomycin and steroids.
OBJECTIVE
Endobronchial tuberculosis (EBTB) is defined as a tuberculous infection of the tracheobronchial tree. It has been reported that aerosolized therapy with streptomycin and steroids is useful for EBTB; however, the effectiveness of this therapy for bronchial stenosis has yet to be clarified. This study was undertaken to determine the effectiveness of aerosol therapy in the treatment of bronchial stenosis due to EBTB.


METHODS
An observational, historical, controlled comparative study. Retrospective analysis of 27 patients treated with conventional therapy, and prospective analysis of 30 patients treated with aerosol therapy.


METHODS
Flexible bronchoscopy was performed at least twice in 57 patients with ulcerative EBTB, in whom the degree of bronchial stenosis between the first and last bronchoscopic examinations was estimated. Bronchial stenosis was graded as minimal, mild, moderate, severe or obstructive, and the follow-up of bronchial stenosis assessed as aggravation, no change or improvement.


RESULTS
Conventional therapies led to aggravation in 13 patients, no change in 13 patients, and improvement in one patient. Aerosol therapy led to no change in 27 patients, and improvement in three patients. No patients developed aggravation. The differences between the therapeutic groups were significant.


CONCLUSIONS
Aerosol therapy helps to prevent progressively severe bronchial stenosis due to EBTB.
Rikimaru
T
T
First Department of Medicine, Internal Medicine, Kurume University School of Medicine, Japan. riki@med.kurume-u.ac.jp
Koga
T
T
Sueyasu
Y
Y
Ide
S
S
Kinosita
M
M
Sugihara
E
E
Oizumi
K
K
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use*; D001982:Bronchial Diseases / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D003251:Constriction, Pathologic / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D003907:Dexamethasone / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009278:Naphazoline / Q000627:therapeutic use; D014663:Nasal Decongestants / Q000627:therapeutic use; D011446:Prospective Studies; D012189:Retrospective Studies; D013307:Streptomycin / Q000627:therapeutic use*; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D014456:Ulcer / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology
D000893:Anti-Inflammatory Agents; D000904:Antibiotics, Antitubercular; D014663:Nasal Decongestants; D003907:Dexamethasone; D009278:Naphazoline; D013307:Streptomycin