Eosinophilic lung disease with plastic bronchitis and bronchiectasis in an adolescent male

Abstract

Any case of unresolving chronic pneumonia with expectoration of thick mucoid plugs should have high index of suspicion for plastic/cast bronchitis, requiring early flexible bronchoscopy with lavage and histopathologic evaluation. Associated presence of idiopathic chronic eosinophilic pneumonia is unusual and could be considered as a cause for atypical plastic bronchitis complicated by bronchiectasis.

Keywords: bronchiectasis; bronchoscopy; eosinophilic lung disease; interstitial lung disease; plastic/cast bronchitis.

Figure 1

Bronchoscopy: Left lower lobe main bronchus with obstructing thick pale yellow mucus plug with surrounding inflammation

Figure 2

CT Scan: Complete occlusion of left main lower lobe bronchus extending to segmental and sub‐segmental bronchi with partial sparing of superior segmental bronchus, with opacification of diffusely dilated left lower lobe bronchi