Tuberculous bronchoesophageal fistulae in patients infected with the human immunodeficiency virus: three case reports and review.

Abstract

To our knowledge, < 30 patients with tuberculous bronchoesophageal fistulae have been described in the English-language literature. However, the overall incidence of infection due to Mycobacterium tuberculosis has been increasing during the epidemic of human immunodeficiency virus (HIV) infection. We describe three HIV-infected patients who presented with tuberculous esophagomediastinal fistulae during their initial illness. Fistulous connections appeared to be secondary to mycobacterial mediastinal adenopathy. All fistulae healed with antituberculous therapy and nasogastric feeding, and surgical intervention was not necessary. The combination of mediastinal lymphadenopathy, cough, and retching or vomiting should alert clinicians treating HIV-infected patients to the possibility of tuberculous bronchoesophageal fistulae.