Plastic bronchitis is characterized by the acute and often recurrent development of bronchial casts witch cause obstruction of tracheobronchial tree. The casts take the shape of the bronchi in witch they formed. Plastic bronchitis can occure in cystic fibrosis, asthma, allergic bronchopulmonary aspergillosis, pneumonia, bronchectases, and idiopatic states. We would like to present otherwise healthy four years old boy who was admitted to a hospital because of fever, cough and dyspnea. On physical examination he had markedly asymmetrical chest with less prominent left hemithorax. The breath sounds were diminished on the left side and crepititions on the right lung. A chest radiograph revealed mediastinal shift to the left, atelectasis of left lower lobe, small parenchymal infiltrates in the middle part of right lung and eleven ribs on the left side. He was treated with antybiotics and fever and dyspnea resolved. Because of persisted atelectasis he underwent diagnostic bronchoscopy. The finding was white rubbery cast branching into the left main bronchus. The cast was removed with the forceps and rigide bronchoscope. The cast was composed primary of fibrine and inflamatory cells, culture was negative. Controlled bonchofiberoscopy revealed no changes in bronchial tree. The child recover completly. Conclusion. Plastic bronchitis should be considered as a reason of athelectasis even in otherwise healthy children.
Full conference title:
15th European Respiratory Society annual conference
- ERS 15th (2005)