Postintubation tracheal rupture associated with tuberculous tracheitis

A 53-year-old female presented to the emergency department with active pulmonary tuberculosis. There was evidence of tracheal involvement on computed tomography (CT) chest imaging. She required emergent intubation and mechanical ventilation for respiratory distress and sepsis. Bronchoscopy revealed contained dehiscence of the cartilaginous from the membranous trachea consistent with tracheobronchial rupture (TBR). Worsening cuff leak, and difficulty ventilating necessitated intervention to stabilize the airway. Attempts at open tracheostomy with cuff placement distal to the injury were unsuccessful. Extracorporeal membrane oxygenation (ECMO) initiation was complicated by vascular injury to which the patient succumbed. Here we present bronchoscopic and radiographic findings of TBR in the setting of active tuberculous tracheitis.