Linfadenitis intratoracica, falla respiratoria y muerte por tuberculosis
Fatal respiratory failure due to tuberculous intrathoracic lymphadenitis
Iatreia; 2 (1), 1989
Publication year: 1989
La linfadenitis tuberculosa del adulto afecta los ganglios intratoracicos solo en 5-7% de los casos y generalmente produce poco compromiso sistemico. Se presenta el caso de una mujer de 21 anos que murio en insuficiencia respiratoria debida a la obstruccion bronquial causada por grandes adenopatias hiliares y mediatinales y derrame pleural masivo bilateral. La incidencia de tuberculosis pulmonar en Medellin durante 1986 fue de 85.3 casos nuevos por 100.000 habitantes, de los cuales muere aproximadamente 8-9% por ano. De la mortalidad en general, menos del 2% se debe a insuficiencia respiratoria. No se encontraron informes en la literatura medica de obstruccion bronquial por linfadenopatia tuberculosa como causa de muerte. Se piensa que las malas condiciones socioeconomicas, el consumo de narcoticos y la coexistencia de enfermedades venereas, contribuyeron al curso fulminante de esta paciente. Se pretende llamar la atencion acerca de esta presentacion atipica y agresiva de la tuberculosis, especialmente en pacientes que pudieran estar inmunocomprometidos
Tuberculous Iymphadenitis in adults affects intrathoracic lymph nodes in only 5- 7% of the cases and It usually does not produce Important systemic involvement. The case of a 21 year-old woman who died of respiratory insufficiency due to bronchial obstruction caused by large hilar and mediastinal lymphadenopathies and bilateral massive pleural effusion is presented. The incidence of pulmonary tuberculosis was 85.3 new cases per 100.000 inhabitants in 1986, in Medellín, Colombia. Mortality can be calculated between 8-9% per year and, of them, only 2% die as a result of respiratory insufficiency. No previous report9 of fatal bronchial obstruction due to tuberculosis Iymphadenopathy were found in the literature. Poor socioeconomic conditions, narcotic drug consumption and the concurrent venereal diseases the presented contributed to the fulminant course observed in this patient. Attention Is called to this atypical as well as aggressive form of tuberculosis, specially when It occurs in patients that might be immunosuppressed