ArticleBMC infectious diseases2026
Bronchoscopic manifestations and epidemiological characteristics of lymph node fistula-type tracheobronchial tuberculosis in Hunan Province, China (2019-2023).
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aimed to investigate the epidemiological characteristics, clinical features, bronchoscopic manifestations, and imaging findings of lymph node fistula-type tracheobronchial tuberculosis (TBTB) in Hunan Province, China, from 2019 to 2023, to provide insights for improved diagnosis and management.
methodsA retrospective analysis was conducted on 933 hospitalized cases of lymph node fistula-type TBTB in the rupture stage, identified from the bronchoscopy electronic medical record system at Hunan Chest Hospital. Patients were stratified into elderly and non-elderly groups. Comparative analyses were performed on demographics, clinical symptoms, laboratory parameters, bronchoscopic subtypes, pathogen detection, and imaging findings.
resultsPatients were stratified into elderly (≥ 60 years, n = 424) and non-elderly (< 60 years, n = 509) groups. The mean patient age was 53.30 ± 18.42 years, with males slightly outnumbering females (52.09% vs. 47.91%). Elderly patients exhibited a male predominance (male-to-female ratio of 1.62:1), whereas the non-elderly group had a female predominance (male-to-female ratio of 0.57:1). Laboratory findings revealed lower hemoglobin and albumin levels but higher erythrocyte sedimentation rates (ESR) in elderly patients (P < 0.05 for all comparisons). Bronchoscopic examination identified ulcerative-perforative (47.91%) and granulomatous-proliferative (43.84%) as the most common fistula subtypes, with the former predominating in elderly patients (80.66%) and the latter in non-elderly patients (70.14%). Pathogen detection rates were higher in BALF samples (67.52%) than in sputum samples (57.88%), with elderly patients exhibiting higher positivity rates (P < 0.05). Chest CT showed mediastinal or hilar lymphadenopathy in 72.78% of cases, with partial calcification more common in elderly patients. Correlation analysis revealed that ulcerative-perforative subtypes were associated with older age, female sex, longer symptom duration, and higher ESR, while granulomatous-proliferative subtypes were linked to younger age, male sex, and better nutritional status.
conclusionsLymph node fistula-type tracheobronchial tuberculosis (TBTB) is prevalent in elderly females, who are susceptible to severe ulcerative-perforative lesions closely associated with caseous necrosis and prolonged inflammation. Conversely, younger males mostly present with granulomatous-proliferative subtypes, suggestive of milder inflammation. Bronchoscopy and BALF testing are critical for subtype-specific diagnosis, and tailored management strategies are key to improving patient outcomes. CLINICAL TRIAL NUMBER: Not applicable.
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