Plastic bronchitis in a child with acute dyspnea and atelectasis: A case study

Sunkonkit K; Klibngern H; Mahanupab P; Reungrongrat S

Authors

Sunkonkit K Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Thailand
Klibngern H Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Chiang Mai University, Thailand
Mahanupab P Department of Pathology, Faculty of Medicine, Chiang Mai University, Thailand
Reungrongrat S Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Thailand

Keywords:

Plastic bronchitis, Bronchial cast, Children, Atelectasis

Abstract

Plastic bronchitis is an uncommon pathologic cast formation in the tracheobronchial tree. A bronchial cast can cause a range of conditions ranging from mild to severe that can lead to airway obstruction. We describe a previously healthy one-year-old boy who developed acute left lung atelectasis and respiratory distress due to plastic bronchitis. He pre- sented with a high-grade fever and productive cough. His chest x-ray showed total left lung atelectasis. His condition did not rule out the presence of a foreign body in the airway or an obstruction due to secretion. Plastic bronchitis ob- structing the left main bronchus was diagnosed and removed by rigid bronchoscopy. Bronchoscopy was crucial in this case for both diagnosis and therapeutic cast removal; however, understanding of the regulation of mucus production and clearance is vital for the prevention of new secretion obstructions.

References

1. Panchabhai TS, Mukhopadhyay S, Sehgal S, Bandyopadhyay D, Erzurum SC, Mehta AC. Plugs of the Air Passages: a clinicopathologic review. Chest 2016; 150:1141-57.
2. Jett JR, Tazelaar HD, Keim LW, Ingrassia TS 3rd. Plastic bronchitis: an old disease revisited. Mayo Clin Proc 1991; 66:305-11.
3. Werkhaven J, Holinger LD. Bronchial casts in children. Ann Otol Rhinol Laryngol 1987; 96:86-92.
4. Madsen P, Shah SA, Rubin BK. Plastic bronchitis: new insights and a classification scheme. Paediatr Respir Rev 2005; 6:292-300.
5. Raoufi M, Achachi L, Mrabet FZ, et al. A Rare Case of Idiopathic Plastic Bronchitis. Case Rep Pulmonol 2017; 2017: 4789751. doi: 10.1155/2017/4789751.
6. Brogan TV, Finn LS, Pyskaty DJ Jr, et al. Plastic bronchitis in children: a case series and review of the medical literature. Pediatr Pulmonol 2002; 34:482-7.
7. Rubin BK. Plastic bronchitis. Clin Chest Med 2016; 37:405-8.
8. Demont P, Fehr T, Geiser T, Ott S.R. Bronchial Cast Formation in Plastic Bronchitis. Respiration 2016; 91:325-6.
9. DiCindio S, Theroux M, Costarino AT Jr, Cook S, O'Reilly R. Plastic bronchitis: a case report. Paediatr Anaesth 2004; 14:520-3.
10. Cho YK, Oh SM, Choi WY, et al. Fatal plastic bronchitis with eosinophilic casts in a previously healthy child. Korean J Pediatr 2009; 52:1048-52.