The bleeding lesion that was seen on bronchoscopic examination is considered the ruptured lymph node. We think that the granulomatous material from the ruptured node moved distallv and obstructed the left main bronchus.

Clinicians need to be aware of this manifestation because this case could easily be confused clinically with foreign body aspiration. A recent review of 20 adult patients with endobronchial tuberculosis found that all of their patients exhibited cough, 25 percent exhibited hemoptysis, and 35 percent exhibited dyspnea. However, none of these patients exhibited acute onset of dyspnea. In the future, endobronchial tuberculosis may be encountered more often in patients with the acquired immunodeficiency syndrome (AIDS). Patients with AIDS often exhibit unusual manifestations of tuberculosis, including mediastinal lymphadenitis and even endobronchial tuberculosis. more

With this experience, we can suggest that obstructive endobronchial tuberculosis must always be kept in mind in the differential diagnosis of foreign body aspiration.
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