Bronchial tree-shaped mucous plug in cystic fibrosis: imaging-guided management

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• 作者：Ignazio Salamone ; Baldassare Mondello ; Maria Cristina Lucanto ; Simona Cristadoro ; Mariangela Lombardo and Mario Barone
• 刊名：Respirology Case Reports
• 出版年：2017
• 出版时间：March 2017
• 年：2017
• 卷：5
• 期：2
• 全文大小：6424K
• ISSN：2051-3380

文摘

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.