TRACHEOESOPHAGEAL FISTULA IN AIDS - STENT VERSUS PRIMARY REPAIR

Tracheoesophageal fistula arising secondary to Mycobacterium tuberculo us infection in AIDS patients is extremely rare. We describe a case wi th a fistula lesion that initially failed to close using a four-drug a ntituberculosis regimen. The original lesion closed following placemen t of an esophageal stent. However, the stent migrated, causing an iatr ogenic tracheoesophageal fistula that needed surgical repair. Tracheoe sophageal fistula (TEF) is an uncommon clinical condition, most freque ntly arising as a sequelae to esophageal malignancy. Iatrogenic injury to the membraneous trachea secondary to cuffed endotracheal or trache ostomy tubes in the presence of an in-dwelling nasogastric tube and co rrosive bums, accounts for most of the remainder of occurring fistulas . Infections such as candidiasis, syphilis, and tuberculosis are also known to cause this condition.(1) We report stent migration with perfo ration and subsequent TEF formation in an HIV-positive patient who ori ginally had stent placement for a tuberculous tracheoesophageal fistul a.