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Necrotizing tracheobronchitis identified on an indium-111-white blood cell scan
1Nuclear Medicine Department, St. Luke's Medical Center, Milwaukee, Wisconsin.
Summary
Necrotizing tracheobronchitis (NTB) is common in neonates but rare in adults. This case highlights an unusual adult NTB diagnosis during mechanical ventilation via an 111In white blood cell scan.
Area of Science:
- Medicine
- Pulmonology
- Critical Care
Background:
- Necrotizing tracheobronchitis (NTB) is a recognized condition in pediatric patients, often associated with mechanical ventilation.
- Incidence in neonatal autopsies ranges widely from 4% to 44%, with prolonged assisted ventilation (>3 hours) being a risk factor.
Observation:
- While NTB is primarily documented in neonates, similar conditions like hemorrhagic tracheitis have been reported in adults undergoing high-frequency jet ventilation or conventional mechanical ventilation.
- This report details an atypical presentation of NTB in an adult patient requiring mechanical ventilation.
Findings:
- The diagnosis of tracheobronchitis in this adult patient was incidental, discovered during an 111In white blood cell scan performed for unrelated reasons.
- This case underscores the possibility of NTB occurring in adult patients on mechanical support.
Implications:
- The findings suggest that necrotizing tracheobronchitis should be considered in the differential diagnosis of airway complications in adult patients on mechanical ventilation.
- Further investigation may be warranted to understand the prevalence and diagnostic modalities for NTB in adult critical care settings.