Plastic bronchitis (BP) is usually an evolutionary complication of respiratory conditions such as asthma and / or pre-existing cardiac, and its occurrence in a patient without chronic respiratory pathology remains exceptional.
We report the observation of a seven-year-old child, followed for asthma, who presented with a pneumatic appearance of commonplace, massive atelectasis of the entire left lung. Endoscopic exploration of the tracheobronchial tree confirmed the extensive obstruction of the left tree by bronchial mussels. The evolution was favorable after the extraction and spontaneous rejection of intrabronchial mussels.
Plastic bronchitis (PB) is a rare and frequently fatal condition characterized by expectoration of large, branching bronchial casts
We report a child's observation, followed for asthma, who presented with bronchitis plastic three years after the declaration of his asthma
A seven-year-old boy, with a history of asthma under inhaled corticosteroid therapy, presented 20 days ago rhinorrhea associated with cough and fever at 39-40 ° C, complicated by respiratory distress. On physical examination, he was feverish at 39 ° C, but hemodynamically stable; in moderate respiratory distress, tachypnic, with diminished breath sounds on the left. An anteroposterior chest radiograph revealed complete atelectasis of the left lung
The bronchitis plastic or disease of the bronchial mussels, is a rare affection defined by the extensive obstruction of the bronchial tree by thick molds, ramified and strongly adherent to the bronchial wall; they are rarely eliminated spontaneously in young children. All bronchial levels can be reached, especially the lower lobes; it affects both the child and the adult, but most cases have been reported in children. Its exact prevalence remains unknown and seems underestimated
Plastic bronchitis have been called by different names over the years. It has been referred to as Hoffman’s bronchitis, cast bronchitis, pseudomembranous bronchitis or fibrinous bronchitis
The most widely accepted classification is that of Sear, based on the characteristics of the bronchial cast and the underlying disease: Type I(inflammatory) consists of fibrin casts, Charcot-Leyden crystals and eosinophilia, and is generally associated with allergies or inflammatory diseases; Type II consists of mucin casts and occurs with congenital heart disease
The clinical presentation has a productive cough, dyspnea, pleuritic chest pain, fever and wheezing.
Radiographic evaluation reveals the site of the bronchial cast impaction, demonstrating atelectasis or infiltrates. Hyperinflation is often evident on the contralateral side6. The CT scan allows visualization of impacted casts within the major airways. The diagnosis is usually confirmed by bronchoscopy, demonstrating airway obstruction from bronchial casts our patient is asthmatic
reported association with plastic bronchitis after congenital heart disease; According to Madsen et al. of the 22 cases reported with eosinophilic jets, 12 cases defined an atopic or asthmatic condition
Plastic bronchitis is a rare condition more and more known thanks to the development of endoscopic techniques pediatric. These must be proposed early to prevent the installation of bronchiectasis, and limit the risk asphyxia in children.