Diagnostic challenges of silico-tuberculosis in a case with progressive massive fibrosis – a Zimbabwe case report

Abstract

This is a case study of an ex-gold miner with an exposure duration to silica dust of 13 years, presenting with silico- tuberculosis and progressive massive brosis. We describe his tortuous and expensive route to diagnosis after being treated with antibiotics during his several visits to the local district hospital, and the challenges associated with diagnosis and management of such complicated cases in poorly-resourced developing countries. The case highlights the plight of ex-miners needing continuous medical care after retirement. We recommend the setting up of a dedicated national oc- cupational health surveillance system for ex-workers in Zimbabwe as the key in the prompt investigation and diagnosis of occupational diseases; training and education in occupational health for clinicians in primary healthcare centres; and specic training in the early identication of silicosis, asbestosis and coal workers pneumoconiosis.