H. Kamoun

Management of pulmonary tuberculosis sequelae

Introduction: Pulmonary tuberculosis still raises many problems. The delay in care can affect respiratory functional prognosis. We were interested to difficulties in management of tuberculosis sequelae. Patients and Methods: A retrospective study including patients treated for pulmonary tuberculosis between January 2012 and January 2014. We selected patients with pulmonary sequelae. Results: Sixty-five cases have been collected. 81.5 % were male and 18.5% female. The mean age was 55.6 years ± 13. Seventy seven percent of these patients were smokers. The mean time to the onset of respiratory symptoms related to pulmonary sequelae was 15.6 ± 8 years. The clinical symptoms were dominated by a chronic sputum (74%), dyspnea (68%) and hemoptysis (34%). The thoracic imaging showed: a destroyed lung (46%), bronchiectasis (31%), aspergilloma (14%), emphysema (12.3%), pulmonary fibrosis (7.7%), residual cavity (6.2%) and lung cancer (1.5%). Functional respiratory explorations found a restrictive ventilatory defect in 78% of cases, chronic respiratory failure in 24% of cases. Treatment was essentially medical consisting in ininhaled corticosteroids, theophyllin and long acting beta agonist. Long term oxygen therapy was indicated for 8 patients. Surgery was indicated for only 5 patients whose, 3 of them had symptomatic aspergilloma. During the period of study the average number of hospitalization per year for all patients was 1.68 ± 2. Conclusion: The prevention of tuberculosis sequelae requires both early diagnosis and available treatment of the disease. These lesions increase morbidity and a preventable mortality.