Ko Yousang, Lee Ho-Young, Lee Young-Seok, Kim Mi-Yeong, Lee Young-Min, Seon Kang Mi, Hwan Shin Jeong, Jin Choi Seok, Lee Yang-Haeng, Lee Hyun-Kyung
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Republic of Korea.
Intern Med. 2014;53(16):1819-24. doi: 10.2169/internalmedicine.53.2145. Epub 2014 Aug 15.
Esophagomediastinal fistula secondary to mediastinal tuberculosis (TB) lymphadenitis is a rare and unusual complication. A 32-year-old woman visited our clinic because of chest pain. Computed tomography (CT) demonstrated an esophagomediastinal fistula with subcarinal lymphadenopathy and no remarkable parenchymal lung lesions. The esophagomediastinal fistula was confirmed by esophagoscopy; however, the patient's bronchoscopy findings were unremarkable. The endobronchial ultrasound-guided lymph node aspiration did not confirm a diagnosis of TB. Finally, the patient was diagnosed via a lymph node biopsy. A drug-sensitivity test revealed the presence of a multidrug-resistant pathogen. To the best of our knowledge, this is the first case of esophagomediastinal fistula secondary to multidrug-resistant (MDR-) TB mediastinal lymphadenitis.