Effect of obstructive disease in patients with non-cystic fibrosis bronchiectasis

Extensive research has been devoted to cystic fibrosis-related brochiectasis, compared with non-cystic fibrosis bronchiectasis but the latter is more common and results in significant morbidity and mortality. We assessed the relationship between pulmonary function test [PFT] findings and sputum bacteriology, blood gases, number of hospital admissions and mortality in patients with non-cystic fibrosis bonchiectasis [NCFB]. We conducted a retrospective review of 88 consecutive patients admitted with exacerbation of bronchiectasis over 5 years from 1996 to 2001. Demographic and clinical data collected included gender, age, pulmonary functions, arterial blood gases, sputum bacteriology during stable and exacerbation periods, and number of hospital admissions due to exacerbation of bronchiectasis. A comparison was made between patients having obstructive airway disease [OAD group] and patients with normal or restrictive pulmonary functions [non-OAD group]. OAD in patients with NCFB adversely affected clinical outcome. There was a significant increase in Pseudomonas colonization [60.3% vs. 16%; P<0.0003], hypercapnic respiratory failure [63.4% vs. 20%; P<0.0003], and mean number of admissions due to exacerbation [6 vs. 2; P<0.0001] in the OAD group as compared with the non-OAD group. Although mortality was increased in the OAD group, the difference was not statistically significant. Patients with NCFB who have OAD have a significantly higher rate of colonization with Pseudomonas aeruginosa [PSA], hypercapnic respiratory failure, a greater number of hospital admissions due to exacerbation of bronchiectasis, and a higher mortality compared with patients with restrictive or normal pulmonary functions

Tuberculosis presenting as endobronchial tumor

Endobronchial tuberculosis TB can be present in various forms including ulceration, hyperemia and granulation tissue and rarely as mass lesion. We present a case of TB presenting as endobronchial tumor mimicking lung cancer on bronchoscopic examination. The histology of the tumor showed caseating granuloma and bronchial lavage culture was positive for mycobacterium TB. The patient improved after anti TB treatment. Endobronchial TB is usually a complication of primary pulmonary TB mostly occurring in children but can occur in adults. The most common form of endobronchial TB is mucosal hyperemia and erosions leading to ulceration and granulation tissue. Cough is the most common symptom and the most serious complication is bronchial stenosis. Several treatment modalities have been tried to decrease the incidence of bronchial stenosis including isoniazid inhalation and systemic steroids but results are not convincing. Early diagnosis and treatment is essential to prevent this debilitating complication