Open AccessBronchial tree‐shaped mucous plug in cystic fibrosis: imaging‐guided management
Author(s) -
Salamone Ignazio,
Mondello Baldassare,
Lucanto Maria Cristina,
Cristadoro Simona,
Lombardo Mariangela,
Barone Mario
Publication year - 2017
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.214
Subject(s) - medicine , atelectasis , cystic fibrosis , bronchiectasis , bronchus , radiology , bronchoscopy , forceps , lung , surgery , respiratory disease
We report the case of a 17‐year‐old boy with cystic fibrosis ( CF ) who presented with persistent cough; after starting intravenous antibiotics for Pseudomonas aeruginosa he underwent a computed tomography ( CT ) scan of the chest. CT revealed extensive consolidation in the right lower lobe with relative bronchus obstruction; the cause of bronchial obstruction was detected in the mediastinal window, corresponding to a bronchial tree‐shaped, thick, tenacious mucous plug. This was extracted 48 h after unresponsive bronchial washing and endobronchial instillation of rhDNAse , using foreign‐body forceps, with subsequent resolution of cough. This case, which is the second report of plastic bronchitis in CF , was resolved by mechanical removal of the mucous plug, suggesting that a careful observation of CT imaging may guide intervention aimed at resolution of atelectasis.