Plastic Bronchitis in a 4 Year-Old Boy Presenting with a Foreign Body Aspiration: A Rare Entity

Abstract

Plastic bronchitis is a rare disease of pediatric age resulting from the fibrinous mucus plugs obstructing the airway. Plastic bronchitis can be secondary to many pulmonary and systemic diseases; but also it can be idiopathic. It is an important entity because it can present with acute respiratory system failure symptoms like non-productive cough, dyspnea and wheezing mimicking foreign body aspiration. Here, we present a 4-year-old boy diagnosed as plastic bronchitis by bronchoscopy. A 4-year-old boy was brought with cough and difficulty in breathing. He had wheezing and dyspnea in pyhsical examination and blood oxygen saturation was 92% without any other clinical and laboratory signs of infection. Chest X-ray and computerized tomography showed characteristics of foreign body aspiration. He was diagnosed as plastic bronchitis by flexible bronchoscopy and had full recovery after extraction of the plugs by aspiration in a bronchoscopy session. Plastic bronchitis is a rare entity of pediatric age. Patients who have respiratory failure resistant to conventional medical therapy; especially if they have radiologic signs of atelectasia or intraluminal blockage, should be evaluated with bronchoscopy.

Plastic bronchitis during childhood: Diversity of presentation, etiology, treatment, and outcomes

“…PB should be considered in patients with atelectasis on chest X-rays. [15][16][17] Girit et al 15 reported a 4-year-old male patient who presented with a cough. Atelectasis was detected in the right upper pulmonary lobe, and he underwent bronchoscopy with the prediagnosis of foreign body aspiration.…”

“…The final diagnosis was PB, and he was treated with flexible bronchoscopy. 15 However, atelectasis can be associated with pediatric asthma in as many as 1.62% of cases and is usually localized to the medial segment of the middle lobe and the lingula. 18 In our PB case series, atelectasis, and asthma were among the most common presenting and underlying conditions, diffuse obstruction of the central airways.…”

“…PB should be considered in patients with atelectasis on chest X‐rays 15–17 . Girit et al 15 reported a 4‐year‐old male patient who presented with a cough.…”

“…Atelectasis was detected in the right upper pulmonary lobe, and he underwent bronchoscopy with the pre‐diagnosis of foreign body aspiration. The final diagnosis was PB, and he was treated with flexible bronchoscopy 15 . However, atelectasis can be associated with pediatric asthma in as many as 1.62% of cases and is usually localized to the medial segment of the middle lobe and the lingula 18 .…”