Bronchiolitis obliterans due to toxic epidermal necrolysis with structural evaluation using computed tomography bronchography: A case report
Hidemasa Kudo1, Ken Katsuta1, Shigeki Kushimoto1
1Department of Emergency and Critical Care Medicine Tohoku University Hospital Sendai Japan.
Background:
Toxic epidermal necrolysis (TEN) can lead to various extracutaneous complications, including respiratory involvement. We present a case of a patient who developed bronchiolitis obliterans (BO) after the acute phase of TEN, with computed tomography (CT) bronchography revealing bronchial tree structural changes.
Case Presentation:
A 60-year-old woman presented with a rash and hoarseness 2 days after taking ibuprofen and was diagnosed with TEN. While her cutaneous symptoms improved by day 20, the flow-volume loop indicated obstructive respiratory failure. CT bronchography revealed bead-like changes and mural irregularities in the bronchi; thus, BO was diagnosed. Despite treatment with bronchodilators and steroids, she required long-term mechanical ventilation with persistent bronchial alterations.
Conclusion:
Extracutaneous complications of TEN are crucial, particularly in BO development following the acute phase. In this case, CT bronchography showed treatment-refractory bead-like changes and mural irregularities in the bronchioles.
Related Concept Videos
Chronic Obstructive Pulmonary Disease-II: Pathophysiology
Chronic Inflammation
Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
Pneumothorax-II
Clinical Manifestations:
Pulmonary Cycle: Exhalation
Chronic Obstructive Pulmonary Disease-I: Introduction
Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...


