The obstructive phenotype of chronic posttuberculosis disease - is there a role for the occupational exposure?

Tuberculosis (TB) disease is treatable, but the postTB lung disease in previously treated patients is a reality which must not be ignored. A case report of a 52-year-old male patient, heavy smoker (50 pack-years), alcoholic, with occupational exposure to chemical hazards (such as gaz oil vapors, distillate fuels and industrial solvents), physical hazards (thermal extremes, noise, vibration, UV radiation), ergonomic hazards (manual handling activities); and psychosocial hazards (e.g. overload, isoloation from family and friends), was delayed diagnosed with severe extensive cavitary pulmonary TB disease in 1999, treated till 2001. The assessment of lung function was neglected before or after antiTB therapy ended, so COPD was ignored till 2009, when the patient was admitted in a Pneumology Hospital. Other long term postTB disorders, as left fibrothorax, bronchiectasis, cavitary open healling syndrome, were also identified. Chronic postTB lung disease (PTLD), centered on COPD, had unfavorable progressive evolution till September 2022, when premature death occured. In conclusion, the obstructive phenotype of PTLD was delayed diagnosed and had multiple risk factors as tobacco smoking, occupational exposure and severe TB disease itself. A protocol for monitoring obstructive lung disorders among workers in oil industry, especially those diagnosed with TB disease, should be properly adapted through a collaborative approach between the occupational and the chest physician.