IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-8-4-18966 Original Research Paper THE BUDDING TUBERCULOSIS Reddy Dr. Anand Sude Dr. April 2019 8 4 01 02 ABSTRACT

Endobronchial Tuberculosis (EBTB) is recognised less often, has bad consequences and causes spread of infection in the community. It has been defined as “tuberculosis infection of the tracheobronchial tree with microbial and histopathological evidence or “a complication of progressive primary Tuberculosis”. An 8yr old male child, presented with non–remitting cough low grade fever and weight loss since 1 month. There was past history of non–resolving pneumonia 4 months back. There was no family history of tuberculosis. On examination the child was malnourished, anaemic with bitot spots. Chest findings revealed diminished movements and decreased breath sounds over the left hemithorax. Investigations showed elevated total WBC counts.ESR was elevated. Tuberculin skin test was negative. Sputum smear examination and culture was normal. Chest X–ray showed patchy infiltration and consolidation in the sleft lower lobe.Child was given 10 days of I.V antibiotics before referral. Despite 10 days of antibiotics child did not improve and radiographic opacities worsened so bronchoscopy was done which revealed mild hyperaemic tracheobronchial mucosa with no evidence of stenosis. Microbiological culture and smear examination of BAL fluid was negative for AFB.HRCT revealed multiple nodular opacities with multiple centrilobular branching opacities in V–Y pattern (tree in bud pattern) involving bilateral lung fields with areas of consolidation in the inferior lingual segment of left upper lobe. A diagnosis of Endobronchial tuberculosis was made and child was started on category 1 AKT along with corticosteroids. Child has clinically improved after 2weeks and is on a regular follow up.