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Everything That Wheezes Is Not Asthma: A Case Report
Sagar K Shah1, Natalie Sabzghabaei1,2,3,4
1Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan, USA.
Pediatric Allergy, Immunology, and Pulmonology
|June 18, 2021
Summary
Plastic bronchitis (PB) is a rare condition where patients form casts in their airways. This case highlights PB in a child with asthma, emphasizing prompt diagnosis and treatment to prevent life-threatening airway obstruction.
Area of Science:
- Pediatrics
- Pulmonology
- Rare Diseases
Background:
- Plastic bronchitis (PB) is a rare condition characterized by the formation of bronchial casts.
- While often associated with congenital heart defects, PB can occur in otherwise healthy individuals.
- Known causes include Influenza A, lymphatic abnormalities, and single ventricle physiology; asthma is a proposed risk factor.
Observation:
- A 9-year-old boy with uncontrolled asthma presented with cough, fever, chills, and weight loss.
- Initial treatment for presumed necrotizing pneumonia was unsuccessful.
- Diagnostic bronchoscopy revealed plastic bronchitis.
Findings:
- The patient's uncontrolled asthma was identified as the sole predisposing respiratory condition.
- Treatment with corticosteroids, chest physiotherapy, and fibrinolytic therapy led to significant symptom and imaging improvement.
Implications:
- This case underscores the importance of considering plastic bronchitis in pediatric patients with unexplained respiratory symptoms.
- Delayed diagnosis and treatment of PB can lead to fatal airway obstruction.
- A thorough history, broad differential diagnosis, and holistic patient management are crucial for pediatricians.
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