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Published on: May 8, 2017
Bronchial tree-shaped mucous plug in cystic fibrosis: imaging-guided management
Ignazio Salamone1, Baldassare Mondello2, Maria Cristina Lucanto3
1Oncological Radiology Unit, Department of Biomedical and Dental Sciences and Morphofunctional Imaging Policlinico G. Martino Hospital - University of Messina Messina Italy.
Insights
This case study highlights a rare instance of plastic bronchitis in a cystic fibrosis (CF) patient. Mechanical removal of a mucus plug successfully resolved symptoms, emphasizing CT imaging
Area of Science:
- Pulmonology
- Medical Case Reports
Background:
- Cystic Fibrosis (CF) is a genetic disorder affecting the lungs.
- Plastic bronchitis is a rare complication characterized by the formation of mucus casts in the bronchial tree.
Abstract:
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.
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