Oesophagomediastinal fistula: a rare complication of tuberculosis

Maurizio Nedkov Gambin; Sarah Marie Vella; Chantal Vella; John Schembri

doi:10.1136/bcr-2021-242907

Oesophagomediastinal fistula: a rare complication of tuberculosis

BMJ Case Rep. 2021 Sep 3;14(9):e242907. doi: 10.1136/bcr-2021-242907.

Authors

Maurizio Nedkov Gambin¹, Sarah Marie Vella², Chantal Vella², John Schembri²

Affiliations

¹ Department of Medicine, Mater Dei Hospital, Msida, Malta mebemau@gmail.com.
² Department of Medicine, Mater Dei Hospital, Msida, Malta.

Abstract

We report a case of a woman from Thailand, living in Malta, who was diagnosed with concomitant tuberculosis (TB) and HIV with depleted CD4 count. Her case was further complicated by the formation of a fistula between the mediastinal lymph nodes and the oesophagus, an unusual finding but for which she had many risk factors. The diagnosis was suspected on CT scan of the thorax and confirmed via upper gastrointestinal endoscopy. Following the commencement of both anti-TB and antiretroviral therapy, she suffered a lapse of immune reconstitution inflammatory syndrome but with aggressive medical management eventually made a full recovery without the need for surgical intervention.

Keywords: HIV / AIDS; TB and other respiratory infections; oesophagus.

Publication types

Case Reports

MeSH terms

CD4 Lymphocyte Count
Female
Fistula* / diagnostic imaging
Fistula* / etiology
HIV Infections* / complications
HIV Infections* / drug therapy
Humans
Immune Reconstitution Inflammatory Syndrome*
Tuberculosis* / complications
Tuberculosis* / diagnosis
Tuberculosis* / drug therapy