Eosinophilic plastic bronchitis - A case report

An airway foreign body can be a life threatening, otolaryngologic emergency that requires prompt evaluation and intervention. Plastic bronchitis is a rare and underrecognized cause of bronchial casts associated with a history of cardiac surgery, inflammatory airway diseases, and infections. We report a unique case of a 7-year-old male who presented with minimal respiratory distress, and radiological evidence of complete left lung collapse, initially concerning for an airway foreign body. Bronchoscopy revealed airway cast consistent with eosinophilic plastic bronchitis. He required two bronchoscopies for treatment, with cryotherapy proving essential for accessing friable distal airway casts. Lung re-expansion was achieved and patient has remained asymptomatic without recurrence on follow-up. Cryotherapy is a safe and effective technique to remove an airway foreign body or friable bronchial casts and should be utilized early when traditional treatments are not effective. Collaboration between otolaryngology and pulmonology is essential for optimal outcomes.