A 1-year-old boy with near-complete tracheobronchial obstruction from endobronchial tuberculosis.
Qionghua Chen, Jingyang Zheng, Li'e Zeng et al.
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Case in brief
A one-year-old boy presented with cough and worsening wheezing, leading to a chest CT that revealed obstructing endobronchial lesions. Physical examination showed tachypnea and diminished breath sounds. Despite advanced testing, the diagnosis of endobronchial tuberculosis was initially missed and confirmed only after a multi-institutional pathology review identified a rare acid-fast bacillus. The patient experienced near-complete tracheobronchial obstruction.
What made this case unusual
The case highlights a rare presentation of pediatric tuberculosis with near-complete tracheobronchial obstruction, which is uncommon in infants.
Diagnostic / clinical pearl
Clinicians should consider endobronchial tuberculosis in infants presenting with respiratory distress and obstructive lesions, especially when initial tests are inconclusive.
Why it matters
This case underscores the importance of thorough histopathological evaluation in cases of suspected tuberculosis, as initial diagnostic methods may fail to identify the disease.