ABSTRACT

The case study of a woman with diagnosis of refractory pneumonia and abscess is reported Klebsiella spp. was identified and oncotic cytology was negative in bronchial washings, but there was no significant improvement with treatment. She had seizures and right hemiparesis followed by respiratory insufficiency and death. Complete autopsy revealed an esophageal pulmonary fistula with walls infiltrated by pulmonary carcinoma, and cerebral metastasis. This report can exemplify the crucial role of necropsy study to clear clinical misconceptions.

KEYWORDS

Esophageal pulmonary fistula, necropsy, undifferentiated pulmonary carcinoma.

REFERENCES

1. Buemi L, Stefanelli S, Bichard P, Luscher M, Becker M. Esophageal pulmonary fistula-a rare complication of radiation therapy: a case report. J Med Case Rep 2018;12(1):116. doi: 10.1186/s13256-018-1658-3.

2. Duma N, Barlow C, Sanchez L, Sadikot S. Bronchial-oesophageal fistula: a rare initial presentation of squamous cell carcinoma of the lung. BMJ Case Rep 2015;2015. pii: bcr2014209103. doi: 10.1136/bcr-2014-209103.

3. McCartney C, Moghadam A, Sriram KB. Lung adenocarcinoma masquerading as refractory Klebsiella pneumoniae. BMJ Case Rep 2014;2014. pii: bcr2013202993. doi: 10.1136/bcr-2013-202993.

4. Öztürk Ö, Köksal D, Emri S. Tracheoesophageal fistula in a treatment naive patient with lung cancer. Tuberk Toraks 2014;62(2):174-176. doi: 10.5578/tt.7278.

5. Zhou C, Hu Y, Xiao Y, Yin W. Current treatment of tracheoesophageal fistula. Ther Adv Respir Dis 2017;11(4):173-180. doi: 10.1177/1753465816687518.

6. Rajdev K, Siddiqui AH, Ibrahim U, Patibandla P, Khan T, El-Sayegh D. An unusually aggressive large cell carcinoma of the lung: undiagnosed until autopsy. Cureus 2018;10(2):e2202. doi: 10.7759/cureus.2202.