Exploring Silico-tuberculosis: A Detailed Investigation of 45 Cases in Occupational Settings

Abstract

Objective: Silicosis is a lung disease caused by inhaling crystalline silica dust, leading to inflammation and scarring of lung tissue. This retrospective study investigates the association between silicosis and tuberculosis (TB) in occupational settings, analyzing 45 male silicosis patients at Ibn Rochd University Hospital in Casablanca from June 2003 to December 2023. Cases: The average duration of occupational exposure was 18 years, primarily in well-digging, stone crushing, mining, and masonry. Clinical symptoms included dyspnea (89%), persistent bronchial syndrome (83%), and hemoptysis (54%). Imaging typically revealed pseudo-tumoral opacities, often with associated mediastinal lymphadenopathy and micronodular or excavated opacities. TB diagnosis was confirmed by GeneXpert (23% in sputum, 70% in bronchial aspirate fluid) and culture (7%). Conclusion: Anti-tuberculous treatment led to clinical improvement in most cases, but there were two deaths from acute respiratory failure and one case of TB relapse. The findings underscore the importance of screening and chemoprophylaxis for TB in managing silicosis. Preventive measures and worker health protections are crucial to reduce the incidence of silicosis and its complications.