Silico-Tuberculosis Mimicking Malignancy.

Silico-tuberculosis is the combination of silicosis and tuberculosis (TB). Symptoms of TB such as dyspnea, cough, and hemoptysis may precede the diagnosis of an endo-bronchial mass lesion on chest imaging. Among workers who were exposed to silica, TB was more common, and experiments indicated that silica inhibits alveolar macrophage activity and severe exposure induces apoptosis. Endobronchial neoplasms, which are tumors primarily affecting the bronchial lumen, are uncommon and may show up in a wide variety of different ways pathologically. Cough, chest discomfort, wheezing, hemoptysis, recurrent pneumonia, and weight loss are common complaints from people with endobronchial tumors. The requirement for additional bronchoscopy and imaging examination is raised when symptoms such as hemoptysis and obstructive pneumonia are present. Endobronchial silicosis lesions are uncommon and develop as a result of broncho lithiasis, the endoluminal erosion of peri bronchial adenopathy, or local bronchial wall silica-induced fibrosis. Endobronchial TB can present in a varied manner, diagnosis is often challenging as there is no specific radiological feature, and sputum acid-fast bacilli several times come out negative. However, a bronchoscopy with or without biopsy is a useful investigation in these cases. The following case is a rare manifestation of endobronchial TB as it mimicked malignancy, describing the difficulties in diagnosis and treating a patient who had both silicosis and endobronchial TB.

Co-infection of Mycobacterium tuberculosis and Mycobacterium leprae Complicated by pulmonary embolism: A rare case report.

A 35-year-old male patient with lepromatous leprosy came to the emergency room (ER) due to breathlessness and chest pain. The patient was diagnosed with pulmonary tuberculosis (TB) after a bronchoscopy and started on antitubercular therapy. However, the patient continued to experience tachycardia and desaturation, and on further evaluation, Computed tomography pulmonary angiography revealed an embolus in the right descending pulmonary artery. The patient was found to have an elevated d-dimer. Further investigation revealed that the cause of the pulmonary thromboembolism (PTE) was the thalidomide medication that the patient was taking for type 2 leprosy reaction. The medication was stopped, and the patient was treated with low-molecular-weight heparin and discharged with apixaban for six months. The patient's condition improved on follow-up. This case is unique due to the rare combination of pulmonary TB, leprosy, and pulmonary embolism brought on by thalidomide administration. Physicians should be aware of the possibility of co-infection of TB and leprosy and the need to rule out thromboembolism when patients are on thalidomide.