Endobronchial Tuberculosis with Lobar Obstruction Successfully Treated by Argon Plasma Coagulation

Abstract

Endobronchial tuberculosis (EBTB) is an infection of the tracheobronchial tree. A 17-year-old male patient with tuberculosis who developed middle lobe syndrome on antituberculous treatment is presented. The patient was admitted with complaints of fever, cough and weight loss. Right paracardiac and perihilar heterogeneous infiltrations were present. During fiberoptic bronchoscopy, the right middle lobe was found to be obstructed. Tuberculosis was diagnosed based on necrotizing granulomas in the bronchial biopsy and culture growth of M tuberculosis. After antituberculous and corticosteroid treatment, progression occurred. The endobronchial lesion was removed with argon plasma coagulation. After bronchoscopy, the patient's radiologic findings and clinical condition improved. In cases progressing despite steroid treatment, alternative treatments may be beneficial.