Bronchial Tuberculosis in Elderly Patients Complicating Respiratory Tuberculosis: Four Years of Experience of the Endoscopy Department

The objective: to analyze clinical, radiological, and endoscopic manifestations of bronchial tuberculosis in elderly patients with respiratory tuberculosis.

Subjects and Methods. Endoscopic examinations conducted in Endoscopy Department of Central Tuberculosis Research Institute from July 1, 2020 to June 30, 2024 were retrospectively analyzed. 4,429 respiratory tuberculosis patients above 18 years old (all HIV-negative) underwent bronchoscopic examinations. Expert-class endoscopes were used: Olympus BF H190 (Olympus CV-190 video system (Olympus Japan)), Pentax EB15 J10 (DEFINA video system (HOYA Corporation Pentax Life Care Division, Japan)), and Fujifilm EB-580S (Fujifilm ELUXEO 7000 video system, Japan) under local or intravenous anesthesia (sedation). Combined rigid bronchoscopy and video bronchoscopy were performed under total intravenous anesthesia with high-frequency mechanical ventilation.

Results. 7 patients with bronchial tuberculosis aged 65 years and older were included in the study, 3/7 (42.9%) of them had a relapse of bronchial tuberculosis. In all cases, diagnosis verification was preceded by a prolonged period of clinical symptoms (median time before diagnosis made 34 (27-59) weeks). Untimely administration of anti-tuberculosis therapy due to late diagnosis led to a prolonged course of bronchial tuberculosis and widespread and deep damage to the walls of the trachea and bronchi. Chronic tuberculosis inflammation led to metaplastic degeneration of the ciliary epithelium, up to grade II dysplasia and the formation of scar stenosis of the trachea, and grades II-III dysplasia of main and lobar bronchi.  

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