[A case of necrotizing tracheitis and tracheobronchomalacia in a patient with severe motor and intellectual...

We report a 23-year-old male patient with severe motor and intellectual disabilities due to sequelae of intracranial hemorrhage, who have had suffered from pneumonia with pleural effusion after influenza infection followed by mechanical ventilation. This patient also had complication of tracheobronchomalacia. Positive pressure ventilation in addition to thoracheocentesis was necessary for the drainage of pleural effusion. Abrupt hypooxygenation during mechanical ventilation revealed the presence of necrotizing tracheitis, which was improved with removal of necrotic tissues by bronchoscopy and inhalation of steroid thereafter. To relieve the compression which worsened the tracheobronchomalacia, partial resection of the sternal bone was performed. This patient died of complications after operation. This case suggests the importance of accurate diagnosis and treatment of the mechanical ventilation complications including necrotizing tracheitis and tracheobronchomalacia which may be life-threating.