Endobronchial Tuberculosis in Anthracotic Bronchitis.

BACKGROUND Endobronchial tuberculosis (EBTB) is a serious form of pulmonary tuberculosis. In EBTB, mycobacterium tuberculosis involves trachea, large airways and bronchial trees Combustion of biomass fuels causes anthracotic bronchitis that is characterized by black pigmentation in bronchial tissue. The majority of anthracotic bronchitis are in aged patients, particularly rural women, that use biomass fuel for cooking or traditional bakery .The aim of this study was to evaluate the endobronchial tuberculosis in anthracotic bronchitis. MATERIAL AND METHODS In total, 483 EBTB patients who underwent flexible bronchoscopy (FB), for various indications, were included. Tuberculosis was confirmed by microbiological analysis of bronchoalveolar (smear and culture for Koch's bacillus) and histopathological methods. EBTB patients were divided in two groups: subjects with anthracotic bronchitis (group 1) and without anthracosis (group 2). Demographic data and important clinical, radiological and bronchoscopic findings were recorded. Chi-squre test and Spss 11.5 software were used for statistical analysis. RESULTS 483 out of 1824 patients who underwent FB had EBTB. 73.7% patients had EBTB and anthracotic bronchitis (versus 27.3% EBTB without anthracosis). The mean age was significantly higher in EBTB and anthracotic bronchitis (68.45 ± 16.31 versus 49.08 ± 14.7). Female/male ratio was 1.4:4 in EBTB and anthracotic group versus 1:1 in non anthracotic patients. Dyspnea, cough, hemoptysis and wheezing were higher in group 1. History of biomass fuel was more significant in EBTB and anthracotic bronchitis. Mass, diffuse infiltration in lower lobes were revealed higher in radiography of group 1. Bronchoscopy showed the higher frequency of bronchial stenosis in EBTB with anthracosis (P value < 0.05). CONCLUSION This study suggested significant association between EBTB and anthracotic bronchitis. Unusual findings in radiological and bronchoscopic features were seen in EBTB with anthracosis.