Endobronchial tuberculosis: characteristics and bronchoscopic findings in children

<b>Introduction:</b> Endobronchial tuberculosis (EBTB) in children can be confused with asthma or foreign body aspiration. In the adult population, Chung HS classification is used based on bronchoscopic findings, but in children a similar study has not been established. <b>Objective:</b> To evaluate the characteristics and bronchoscopic findings of EBTB in children with pulmonary TB. <b>Methods:</b> Retrospective study of EBTB in children at university hospital in the state of Rio de Janeiro, Brazil, over a 10-year period (2009-2019). EBTB was considered if there were endoscopic changes and positive sputum smear and/or culture and/or rapid molecular test for <i>Mycobacterium tuberculosis</i> in bronchial or bronchoalveolar lavage. <b>Results:</b> There were 17 cases between 0 and 18 years of age, with 59% ≤ 10 years. There was a predominance of females (59%). Suspected tuberculosis was the main indication for bronchoscopy following by maintained radiological image. In 6% of cases, the indication was suspected of a foreign body. None of the cases was suspected TBEB. The main symptom was cough. Culture was positive in 82% of cases and rapid molecular testing and smear microscopy in 12% each. Bronchoscopic findings: carina enlargement (59%), extrinsic compression (47%), mucopurulent secretion (23%), caseum (18%), granulomatous lesion (12%), mucosal edema and hyperemia (6%) and clear secretion were observed (6%). <b>Conclusions:</b> EBTB in children is still underdiagnosed. Although the small sample is a limiting factor, the variability of bronchoscopic findings suggests the need for a specific classification for the pediatric population. This may provide a better forecast of the therapeutic result of EBTB, as observed in the adult population.