Peninsula Quan** reporter Qi Juan correspondent Zhao Jie.
23-year-old Xiaoice (pseudonym) inexplicably has chest tightness, difficulty breathing, and sometimes can hear a "silky" wheezing. When I went to a hospital and suspected "bronchial asthma", I began to use bronchodilators, and I was relieved for a while. However, later "asthma" attacks became more and more frequent, and the efficacy of bronchodilators became worse and worse, and glucocorticoids could only be effective after repeated use.
Two months ago, Xiaoice had symptoms such as cough, sputum production, fever, night sweats, and fatigue, and was positive for acid-fast bacilli in sputum, and was suspected of tuberculosis and transferred to Qingdao Chest Hospital for treatment. Chest CT showed that Xiaoice's right main bronchus was significantly narrowed, and the right part of the lung was atelectasis. After respiratory endoscopy, it was found that a large amount of cheese-like material was attached to Xiaoice's right main bronchi, resulting in airway blockage, and tuberculosis bacteria were found in the lavage fluid, and pulmonary tuberculosis and bronchial tuberculosis were diagnosed.
During the hospitalization, in addition to regular anti-tuberculosis**, after 3 times of respiratory endoscopic freezing, balloon dilation, etc.**, Xiaoice's chest tightness and asthma symptoms were significantly better than before. Chest CT reexamination showed that the extent of the lesion was reduced compared with before, the atelectasis was relieved, and the patient's lung function was restored to the greatest extent.
What is bronchial tuberculosis?
Zhou Ran, the attending physician and head of the Endoscopy Center of Qingdao Chest Hospital, introduced that bronchial tuberculosis is a kind of tuberculosis that involves the trachea, bronchial mucosa, submucosa, smooth muscle, cartilage and other places due to Mycobacterium tuberculosis infection.
Bronchial tuberculosis is a kind of tuberculosis, with the common characteristics of tuberculosis, such as low-grade fever in the afternoon, night sweats, fatigue, weight loss, cough, sputum production, etc., among which long-term cough and dyspnea are its prominent features, and wheezing can appear locally on auscultation.
Why is bronchial tuberculosis so difficult to detect? First of all, it is related to the incidence of tuberculosis. Before the founding of the People's Republic of China, the incidence of tuberculosis in China was very high, and with the improvement of medical standards and people's living standards, the incidence of tuberculosis continued to decline, and it was no longer the "mainstream" disease.
Secondly, the symptoms of bronchial tuberculosis are atypical, some patients do not have fever, night sweats, anorexia and other symptoms of tuberculosis poisoning, only manifested as dry cough, especially in young people, the symptoms of the first onset of disease are similar to "bronchial asthma" and other diseases.
Finally, patients with insignificant airway changes may have no abnormal findings in the lungs on chest x-ray, and even CT scans may not have obvious abnormalities in the lung parenchyma, which can easily be misdiagnosed as common diseases such as upper airway cough syndrome.
Zhou Ran, the attending physician and head of the Endoscopy Center of Qingdao Chest Hospital, reminded that when young patients have recurrent asthma attacks and the effect of "bronchial asthma" is not good, they should think of the possibility of "bronchial tuberculosis". For chronic cough, it is necessary to observe whether the shape of the patient's trachea and bronchi is abnormal, and if necessary, respiratory endoscopy can be performed to see his "true face".