[Mounier-Kuhn syndrome - a rare cause of recurrent bronchitis]

A 43-year-old man presented at our emergency room with progressive dyspnea and productive cough. He was in moderate respiratory distress. Symptomatic treatment had so far not led to clinical improvement. He had suffered from similar episodes since adolescence.

An intensive diagnostic investigation was started to evaluate the source of infection and dyspnea. CRP levels were elevated to 26 mg/l. Arterial blood gas analysis showed a moderate hypoxemia with a pO2 of 8.35kPa (63 mmHg) and a pCO2 of 3.84kPa (29 mmHg).

Computed tomography of the chest revealed the diagnosis of trachebobronchomegaly. This rare cause of recurrent bronchitis is named after Mounier-Kuhn who established this diagnosis for the first time. The patient improved under a course with antibiotics and inhaled bronchodilators.

In patients with recurrent bronchitis, an underlying disease of the tracheobronchial system has to be suspected. The Mounier-Kuhn syndrome is only rarely diagnosed because the diagnosis cannot be established by conventional chest x-ray. Computed tomography is the gold standard for diagnosis. Mounier-Kuhn syndrome is likely to lead to severe venilatory failure and death, if untreated.