RARE CASE OF PRIMARY MULTI DRUG RESISTANCE TUBERCULOSIS WITH HUMAN IMMUNODEFICIENCY VIRUS INFECTION AND TRACHEOESOPHAGEAL FISTULA

In 2012, one fourth of the TB cases reported globally occurred in India. Complications due to tuberculosis have increased due to immunodeficiency. Tracheoesophageal fistula is a rare complication of tuberculosis, presenting with recurrent respiratory tract infection and cough while swallowing liquids. Most common reason for fistula could be due to rupture of the caseonecrotic mediastinal lymph node. We are reporting an immunodeficient patient with tracheoesophageal fistula due to tuberculosis. Sputum line probe assay was sent to intermediate research laboratory (IRL Chennai) to assess drug resistance pattern, which showed resistance to rifampicin and sensitive to isoniazid. Patient was diagnosed to have primary multidrug resistance TB as there was no previous history of anti-tuberculous treatment. Tracheoesophageal fistula was managed conservatively with PEG (Percutaneous endoscopic gastrostomy) because of active infection.