Vinatha Kodam, Pradeep Kumar Dasari, Ramesh Vardhelly, Nagender Prasad Chenimilla, Madire Ramulu, Kilaru Hemanth, Sudeep Madisetty, Venkata Nagarjuna Maturu, Kilaru Satish Chandra
Department of Respiratory Medicine, Prathima Institute of Medical Sciences, Nagunur, Karimnagar, India.
Aparna ENT Hospital, Warangal, India.
Indian J Tuberc. 2020 Jul;67(3):400-403. doi: 10.1016/j.ijtb.2019.11.013. Epub 2019 Nov 26.
A 23-year-old-male student, never-smoker presented to our hospital outpatient department with complaints of loss of appetite, unintentional weight loss, fatigue and low-grade fever for two months, hoarseness of voice (HOV) for two weeks. He was evaluated for HOV with video laryngoscopy which demonstrated left vocal cord palsy. Contrast enhanced CT Chest (CECT) was performed for evaluation of mediastinal lesions which revealed multiple peripheral enhancing conglomerate mediastinal lymph nodes. EBUS-trans bronchial needle aspiration (TBNA) and endobronchial biopsy were performed and specimens sent for smear and culture for AFB, Xpert MTB/RIF assay and histopathology. Results were consistent with Mycobacterium tuberculosis (MTB) infection and culture was positive for M. tuberculosis complex. Patient had been started on anti tubercular therapy (ATT) and during his 4th month follow up he showed clinicoradiological improvement without recovery of recurrent laryngeal nerve palsy.
一名23岁的男性学生，从不吸烟，因食欲不振、体重无故减轻、疲劳和低热两个月，声音嘶哑两周前来我院门诊就诊。他接受了视频喉镜检查以评估声音嘶哑情况，结果显示左侧声带麻痹。进行了胸部增强CT（CECT）以评估纵隔病变，结果显示多个外周强化的纵隔淋巴结团块。进行了超声支气管镜引导下经支气管针吸活检（EBUS-TBNA）和支气管内活检，并将标本送去进行抗酸杆菌涂片和培养、Xpert MTB/RIF检测及组织病理学检查。结果与结核分枝杆菌（MTB）感染一致，结核分枝杆菌复合群培养呈阳性。患者已开始接受抗结核治疗（ATT），在第4个月的随访中，他的临床和影像学表现有所改善，但喉返神经麻痹未恢复。
