[Bronchitis Plastica - Acute Dyspnea and Branching Airway Casts]

A 65 year old female presented to the emergency department with dyspnea and progressive cough with very viscous elongated secretion plugs. She suffered from multiple cardiac comorbidities and chronic heart failure. The CT scan of the thorax demonstrated extensive pulmonary infiltrates, unspecific mediastinal lymphadenopathy and enlargement of pulmonary lymph vessels. Bronchoscopy was performed and showed extensive occlusive bronchial casts. We diagnosed a case of bronchitis plastica. Therapy with inhalative heparin led to clinical improvement.

bronchitis plastica is a rare disease with formation of occlusive bronchial casts. They are often found in cardiac disease or lymphatic disease.