From Dust to Casts: Plastic Bronchitis in a Drywall Worker Treated With Thoracic Duct Embolization

Area of Science:

• Pulmonology
• Thoracic Medicine
• Rare Diseases

Background:

• Plastic bronchitis is a rare pulmonary condition often leading to respiratory failure.
• It is typically seen in children but can affect adults.
• Airway obstruction by bronchial casts is the primary pathology.

Purpose of the Study:

• To report a case of adult plastic bronchitis.
• To describe the diagnostic and therapeutic approach.
• To highlight successful management strategies.

Main Methods:

• Flexible bronchoscopy for diagnosis and cast removal.
• Cryoprobe-assisted bronchoscopy for precise cast extraction.
• Thoracic duct embolization to address potential lymphatic abnormalities.

Main Results:

• A large bronchial cast obstructing the left mainstem bronchus was identified.
• The patient experienced recurrent hypoxic respiratory failure.
• Post-intervention, oxygenation improved, and mechanical ventilation was discontinued.

Conclusions:

• Plastic bronchitis can occur in adults, even with occupational exposures.
• A combination of bronchoscopic intervention and management of underlying lymphatic issues can be effective.
• This case underscores the importance of considering plastic bronchitis in unexplained respiratory failure.