[Post-infectious autobullectomy]

Abstract

Introduction: Bullous emphysema is defined as an airspace of more than 10mm in diameter. The spontaneous regression or disappearance of a bulla is unusual, described as an "autobullectomy".

Case report: We report the case of a 37-year-old man with a 10-pack/year history of smoking, a history of pneumothorax surgically treated in 2005, and emphysema with a bulla in the right upper lobe. In September 2010, the patient was hospitalized for a community-acquired pneumonia associated with an air-fluid level in the bulla. Clinical symptoms improved with a course of antibiotics (levofloxacin, ceftriaxone) for 3 weeks. Chest X-rays showed a progressive decrease in the size of the bulla. In June 2011, a chest CT scan showed complete regression of the bulla in the right upper lobe.

Conclusions: We report the complete regression of a bulla after infection, leading to an "autobullectomy". It can be hypothesized that the mechanisms might involve fibrosis of the walls and/or the obstruction of the bronchus supplying the bulla.

Keywords: Bulle; Emphysema; Emphysème; Infection; Pulmonary bulla; Régression spontanée; Spontaneous regression.