Published online Apr 6, 2023. doi: 10.12998/wjcc.v11.i10.2282
Peer-review started: December 22, 2022
First decision: January 20, 2023
Revised: February 1, 2023
Accepted: March 9, 2023
Article in press: March 9, 2023
Published online: April 6, 2023
Processing time: 98 Days and 6.4 Hours
Bronchopleural fistula (BPF) is a relatively rare, but severe complication of pulmonary tuberculosis. It is associated with significant mortality; however, its management remains a major therapeutic challenge.
We present a 24-year-old man with BPF resulting from severe pulmonary tuberculosis combined with mixed infections. The damaged right upper lobe and concomitant empyema were demonstrated via computed tomography. After undergoing open-window thoracostomy and tuberculosis treatment for 4 mo, decortication and right upper lobectomy were subsequently performed, leading to the resolution of tuberculosis and other concurrent pulmonary infections. Follow-up, 6 mo after surgery, failed to reveal any evidence of infection recurrence resulting in a good prognosis.
The disease course of tuberculous BPF is particularly challenging. Surgical intervention serves as an effective and safe therapeutic strategy for BPF.
Core Tip: Bronchopleural fistula (BPF) is a relatively rare but severe complication of pulmonary tuberculosis. However, no consensus has been reached on the ideal treatment modality. This article presents a patient with a BPF resulting from severe pulmonary tuberculosis accompanied by mixed infections. Strict preoperative evaluation of surgical indications, including standard preoperative anti-tuberculosis treatment and controlling the infection through an open-window thoracostomy during surgery, can achieve a satisfactory long-term prognosis for the treatment of BPF through this three-pronged approach.