A Bronchoesophageal Fistula That Developed Shortly After the Initiation of Antituberculous Chemotherapy

A 26-year-old man visited our clinic because of a persistent cough. Although his chest roentgenography showed no abnormalities, a sputum culture revealed a positive result for Mycobacterium tuberculosis. Computed tomography (CT) prior to antituberculous chemotherapy demonstrated an esophagomediastinal fistula with subcarinal lymphadenopathy. One week after the treatment, he complained of a severe cough exacerbated by swallowing liquid. The development of a bronchoesophageal fistula (BEF) was suggested by esophagoscopy, and was confirmed by CT and bronchoscopy. The present case was unique because the process of BEF development could be followed by CT, and the BEF developed in an immunocompetent patient with relatively mild pulmonary tuberculosis.