Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Esophagomediastinal Fistula Secondary to Multidrug-resistant Tuberculous Mediastinal Lymphadenitis
Yousang Ko, Ho-Young Lee, Young-Seok Lee, Mi-Yeong Kim, Young-Min Lee, Mi Seon Kang, Jeong Hwan Shin, Seok Jin Choi, Yang-Haeng Lee, Hyun-Kyung Lee
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Keywords: mediastinal tuberculous lymphadenitis, esophagomediastinal fistula, multidrug-resistant tuberculosis
JOURNAL OPEN ACCESS

2014 Volume 53 Issue 16 Pages 1819-1824

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Abstract

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.

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© 2014 by The Japanese Society of Internal Medicine
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