Bronchiectasis due to pulmonary tuberculosis in a Hospital in the Peruvian Jungle
Bronquiectasias por tuberculosis pulmonar en un hospital de la selva peruana
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Introduction: Pulmonary tuberculosis is a disease with a high prevalence and incidence in Peru. In 2018, the San Martín region had an annual incidence of 34 per 100,000 inhabitants. It is estimated that half of these patients will develop a complication of pulmonary tuberculosis throughout their lives, with bronchiectasis being among the most common.
Objective: To characterize sequelae of bronchiectasis due to treated and cured pulmonary tuberculosis in patients treated at Hospital II-2 Tarapoto from January 2017 to December 2020.
Materials and methods: This study employed observational, descriptive, cross-sectional, and retrospective research, utilizing medical records to characterize post-pulmonary tuberculosis bronchiectasis as a foundation for future research on a little-studied disease. Forty-one cases of bronchiectasis were studied in patients treated for and cured of pulmonary tuberculosis at Hospital II-2 Tarapoto from January 2017 to December 2020.
Results: The most common age group was adults between 30 and 64 years (68.3%), more often in women (58.5%), presenting a normal weight according to BMI (68.3%), and were diagnosed with bronchiectasis more regularly between 1 and 11 years after discharge with cured pulmonary tuberculosis (63.4%). The main symptoms were productive cough (82.9%), dyspnea (43.9%), and chest pain (41.5%). The characteristic sign was subcrackly breath sounds (24.4 %). Both imaging studies were used at nearly equal frequencies when establishing the diagnosis (chest CT in 51.2% and chest X-ray in 48.8%). Bronchiectasis was most frequently affected in the right lung (36.6%) and upper lobes (39%). The most common type of bronchiectasis, as determined by computed tomography (CT), was cylindrical (57.1%). The most frequently isolated bacterial pathogens were Enterobacter gergoviae (24.3%) and Klebsiella pneumoniae (13.5%).
Conclusions: Protocols should be developed to achieve a timelier diagnosis, including guidelines for routine follow-up in patients who have completed tuberculosis treatment and have been discharged to provide early treatment.
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