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Broncholithiasis in an immune compromised boy with disseminated Mycobacterium kansasii

I Cuppen1, W C M de Lange, S S N de Graaf

  • 1Department of Pediatrics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. I.Cuppen@cukz.umcn.nl

Pediatric Pulmonology
|August 28, 2007
PubMed

Insights

Broncholithiasis, a rare condition where calcified lymph nodes obstruct airways, is reported in a child. This case highlights a unique presentation of broncholithiasis in a pediatric patient with disseminated Mycobacterium kansasii infection.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Hematology Oncology

Background:

  • Broncholithiasis, characterized by calcified lymph nodes eroding into bronchi, is uncommon in children.
  • The most frequent etiology of broncholithiasis is Mycobacterium tuberculosis infection.

Observation:

  • A 14-year-old boy with disseminated Mycobacterium kansasii infection and myelodysplastic syndrome presented with cough and fever.
  • Computed tomography and bronchoscopy revealed a large calcified mass eroding the right main bronchus.

Findings:

  • The patient experienced hemoptysis and clinical deterioration, leading to the discovery of acute myeloid leukemic transformation of his myelodysplastic syndrome.
  • Post-mortem examination confirmed a large broncholith originating from a calcified lymph node.

Implications:

  • This case underscores the importance of considering broncholithiasis in pediatric patients with complex infections and hematologic disorders.
  • It highlights a rare association between Mycobacterium kansasii, myelodysplastic syndrome, leukemic transformation, and broncholithiasis in a child.
  • Further research into the pathogenesis and management of pediatric broncholithiasis is warranted.

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