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Post-RSV Bronchial Web Formation in a Lung Transplant Recipient: A Case Report.
Nathan Harb1,2, Alexander Mullin1,3, Celeste Mar1
1Department of Thoracic Medicine and Lung Transplantation St Vincent's Hospital Sydney Australia.
Respirology Case Reports
|April 28, 2025
Summary
Bronchial webs, a rare airway complication, were identified in a lung transplant patient with chronic lung allograft dysfunction (CLAD) after a respiratory syncytial virus (RSV) infection. Balloon dilation provided symptomatic relief, suggesting a potential role for viral infection in web formation.
Area of Science:
- Pulmonology
- Transplant Surgery
- Infectious Diseases
Background:
- Bronchial webs (BW) are rare fibrinous membranes obstructing airways.
- Chronic lung allograft dysfunction (CLAD) is a major complication after lung transplantation.
- Respiratory syncytial virus (RSV) infection can impact lung allograft health.
Purpose of the Study:
- To describe a case of bronchial web formation in a lung transplant recipient with CLAD.
- To investigate the potential role of RSV infection in the pathogenesis of bronchial webs.
- To evaluate the efficacy of balloon dilation for treating bronchial webs in this context.
Main Methods:
- Case report of a 33-year-old female lung transplant recipient with acute lung allograft dysfunction post-RSV infection.
- Bronchoscopic identification of subsegmental bronchial webs in both lung allografts.
- Intervention using 8 mm balloon dilation catheter for web treatment.
Main Results:
- Bronchoscopy revealed multiple subsegmental bronchial webs occluding airway lumens.
- Balloon dilation resulted in immediate symptomatic improvement.
- No significant spirometric improvement was observed post-procedure.
- This case highlights a potential association between CLAD, RSV infection, and bronchial web formation.
Conclusions:
- Bronchial webs may represent an unusual airway complication of the bronchiolitis obliterans syndrome (BOS) phenotype of CLAD.
- RSV infection might play a role in the pathogenesis of bronchial webs in lung transplant recipients.
- This is the first reported case of bronchial web formation following RSV infection in a patient with CLAD, underscoring the potential impact of viral infections on airway complications.
