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Sep 19, 2007Article Details
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Main Article Content
Tuberculosis and phrenic nerve destruction
Abstract
Phrenic nerve palsy (PNP) is often associated with Mycobacterium
tuberculosis-related expansile pneumonia, possibly because
of nerve entrapment by healing fibrosis.
Mohan and Jayaswal1 postulated that pressure on the left
phrenic nerve by an enlarged hilar lymph node caused unilateral
diaphragmatic paralysis in a 6-year-old boy who developed
PNP during the course of pulmonary tuberculosis (PTB). Gie et
al.2 described 6 childhood cases of PTB complicated by unilateral
PNP. The children did not recover on antituberculosis
drugs and steroids, or in 1 case, after surgical decompression.
Therefore the theory of glandular compression alone does not
adequately account for PNP as a complication of PTB. Our case,
in which the fate of the phrenic nerve was confirmed, provides
strong evidence that destruction of the phrenic nerve by the tuberculous
inflammatory process is involved in the pathogenesis
of diaphragmatic paralysis, which may influence the clinical
management of these children.
South African Medical Journal Vol. 97 (8) 2007: pp. 572-573
