Vivek Tharayil1,2*, Teresa Chalmers-Watson2, David Cole4 and Catherine Stedman2,3
1Department of Gastroenterology, Waikato Hospital, New Zealand
2Department of Gastroenterology, Christchurch Hospital, New Zealand
3University of Otago, New Zealand
4Department of General Medicine, Christchurch Hospital, New Zealand
The global burden of tuberculosis remains high. Oesophageal tuberculosis is a rare condition and accounts for 0.3% of all cases of gastrointestinal tuberculosis. Though a rare condition, oesophageal tuberculosis should be considered in patients presenting with dysphagia, especially in high risk populations such as immunocompromised patients and immigrants from high risk countries. We report a case of a young Indian male who immigrated to New Zealand, presenting with dysphagia and odynophagia. Gastroscopy showed a large cratered oesophageal ulcer with the appearance of a fistula at the mid oesophagus. Extensive biopsy sampling showed only focal ulceration with actively inflamed chronic granulation tissue. No Acid Fast Bacilli (AFB) noted and a PCR did not detect Mycobacterium species. There was no dysplasia or malignancy. Computer Tomography (CT) scan of his neck, thorax and abdomen showed a 40 mm × 29 mm × 44 mm, peripherally enhancing soft tissue abnormality in the middle third of the oesophagus, with the mass broadly in contact with the carina. Bronchoscopy and bronchial aspirate culture isolated Mycobacterium tuberculosis. He was started on Anti Tuberculosis Therapy (ATT) and his dysphagia improved. He has ongoing follow up with Infectious Disease specialists.
Dysphagia; Oesophageal ulcer; Tuberculosis
Tharayil V, Chalmers-Watson T, Cole D, Stedman C. Oesophageal Tuberculosis: A Rare Cause of Dysphagia. Ann Clin Case Rep. 2019; 4: 1597.