Abstract:

A case diagnosed as bronchial mucosa keratosis combined with bronchial tuberculosis was reported by Shaanxi Provincial Tuberculosis Hospital and the related clinical information and process for diagnosis and treatment of this patient were analyzed, the relevant literature was reviewed as well. The patient was a 27 years old man, a farmer. He was admitted to the hospital on January 26th, 2014 presenting with fever, cough with sputum, chest pain and dyspnea. No active lesions were seen in chest CT. The fiberoptic bronchoscopy examination showed a large amounts of yellow membranous attachments. Sputum Mycobacterium tuberculosis culture was positive. Pathological examination under fiberoptic bronchoscopy showed that the surface of bronchial mucosa was covered with squamous epithelium combined with hyperkeratosis, which was in accorded with the diagnosis of bronchial mucosal keratosis complicated with bronchial tuberculosis. Anti-TB drugs, isoniazid, rifampicin, pyrazinamide and ethambutol, were given to the patient for anti-tuberculous treatment. At the same time, sodium bicarbonate, dexamethasone and recombinant human epidermal growth factor were repeatedly lavaged under bronchoscopy and bronchoscopic cryo-therapy was also performed. After six months, the attachments were completely absorbed. Four years follow-up was done to this patient, and he had normal work and life. Based on the literature review results, the authors think that the clinical symptoms and signs of bronchial mucosal keratosis complicated with bronchial tuberculosis are lack of specificity. The diagnosis mainly depends on the history and pathological examination. According to the specific situation of the patients, anti-tuberculosis treatment can be implemented, as well as combined fiberoptic bronchoscope cryotherapy and bronchoscopic administration, etc, to cure the patients.

Key words: Bronchial diseases, Tuberculosis, Comorbidity, Case reports, Review literature as topic, Consensus development conferences as topic