Particularities of post-tuberculosis bronchiectasis

Introduction: bronchiectasis is a chronic disabling lung disease which has a significant impact on the daily life of patients. Post-tuberculosis (TB) bronchiectasis, a particular entity, still frequent in the endemic areas despite the BCG vaccination. Aim: determine clinical, spirometric and scannographic particularities of patients with post-TB bronchiectasis. Methods: retrospective comparative study including 92 patients followed for bronchiectasis in pneumology department I of Abderrahmane Mami Hospital, Ariana from 1998 to 2020. Two groups were individualized: G1: patients with post-TB bronchiectasis, G2: patients whose etiology of bronchiectasis is other than sequelae of TB. Results: the prevalence of post-TB bronchiectasis was 22.8% (n=21). G1 patients were older (p=0.007) with a mean age of 62 ± 14 years. Clinical symptoms, blood gas tests, and radiological abnormalities did not differ between the 2 groups. G1 patients presented a higher FEV1/FVC ratio than those of G2 (p=0.039; G1: 84% vs G2: 71.75%). Bronchial superinfection was more frequent in G1 patients (p=0.014). Patients with post-TB bronchiectasis had more suppuration (p=0.04), more episodes of hemoptysis (p=0.002). No difference between G1 and G2 regarding progression to chronic respiratory failure, long-term oxygen therapy, non-invasive ventilation, chronic pulmonary heart and pulmonary hypertension. Conclusion: tuberculosis represents a frequent etiology of bronchiectasis in Tunisia, especially in elderly patients with a higher risk of bronchial superinfection, suppuration and recurrent hemoptysis. Thus, in Tunisia, being a tuberculosis endemic country, early detection and management of pulmonary TB are essential to prevent the evolution towards post-TB sequelae.