Lower lung field tuberculosis

Sixty-five patients with lower lung field tuberculosis were found, representing 5.1 percent of the total admissions with pulmonary tuberculosis over a period of five years. Unlike previous reports, the disease affects more within the old age and female groups. The most common symptoms were cough, followed by chills, fever and hemoptysis. Bilateral or bilobar involvement was infrequent. Common basal segments and middle lobe were the most commonly affected locations. Chest x-ray film showed consolidation in most cases. Sputum smear for AFB was positive in 37 patients. Endobronchial involvement was proved by bronchoscopy in 32 of 42 patients who received the diagnostic procedure. The major bronchoscopic findings were ulcerative granuloma, fibrostenosis, and submucosal infiltration. In rare instances, final diagnosis could be made only after exploratory thoracotomy. Besides its diagnostic merit in lower lung field tuberculosis, bronchoscopy can assess the severity of the endobronchial lesion and provide a guide to early surgical intervention in patients with severe fibrostenosis.