Bronchial tree‐shaped mucous plug in cystic fibrosis: imaging‐guided management. Issue 2 (12th January 2017)

• Record Type: Journal Article
• Authors: Salamone, Ignazio; Mondello, Baldassare; Lucanto, Maria Cristina; Cristadoro, Simona; Lombardo, Mariangela; Barone, Mario
• Is Part Of: Respirology case reports. Volume 5:Issue 2(2017)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-01-12
• Subjects: Atelectasis -- cystic fibrosis -- DNAse -- imaging -- plug; Respiratory organs -- Diseases -- Periodicals; 616.2005
• DOI: 10.1002/rcr2.214
• Languages: English
• ISSNs: 2051-3380

Abstract

Abstract : We report the case of a 17‐year‐old boy with cystic fibrosis (CF) who presented with persistent cough; after starting intravenous antibiotics for Pseudomonas aeruginosa he underwent a computed tomography (CT) scan of the chest. CT revealed extensive consolidation in the right lower lobe with relative bronchus obstruction; the cause of bronchial obstruction was detected in the mediastinal window, corresponding to a bronchial tree‐shaped, thick, tenacious mucous plug. This was extracted 48 h after unresponsive bronchial washing and endobronchial instillation of rhDNAse, using foreign‐body forceps, with subsequent resolution of cough. This case, which is the second report of plastic bronchitis in CF, was resolved by mechanical removal of the mucous plug, suggesting that a careful observation of CT imaging may guide intervention aimed at resolution of atelectasis. Abstract : This is the second report of plastic bronchitis in cystic fibrosis that resolved with mechanical removal of the mucous plug. A careful observation of computed tomography (CT) imaging may guide intervention aimed at resolution of atelectasis.