Endobronchial Tuberculosis in a Patient With Bronchial Asthma Treated With High Doses of Inhaled Corticosteroids

A thirty-seven year-old female patient who was followed with a di­agnosis of bronchial asthma admitted to our outpatient clinic with complaints of chest pain and fatigue. She used high doses of inha­led fluticasone propionate (>1000 micrograms) and long acting be­ta-mimetic inhalers for the last few years. On admission, the pati­ent had a noisy inspiration. Pulmonary function tests were normal except a decreased peak expiratory flow value. A bronchoscopy per­formed for ruling out laringeal dysfunction revealed diffuse nodular yellowish leisons of 1-3 mm. in diameter in the right bronchial sys­tem. Acid fast bacilli (AFB) was negative on a smear of bronchial lavage, while an AFB culture was found to be positive. A second bronchoscopy was performed due to positive culture results and bronchial biopsy of the endobronchial leisons was performed. The pathological examination of bronchial biopsy showed bronchial mucosa with a nonspecific chronic inflammation. The patient was given antituberculous therapy. The complaints of chest pain and fa­tigue disappeared after treatment.