Plastic bronchitis associated with adenovirus serotype 7 in children

Abstract

Background: Plastic bronchitis is an uncommon but severe respiratory disease characterized by formation of casts in tracheobronchial tree. It can lead to airway obstruction and even respiratory failure.

Case presentation: Plastic bronchitis is mostly seen in both post-cardiac surgery patients, especially Fontan procedure, and infections including those caused by influenza viruses, Mycoplasma pneumoniae or tuberculosis. But it has rarely been reported to be associated with adenovirus infection. We report 2 cases of plastic bronchitis arising from adenovirus serotype 7 infection, manifested in repeated high fever, cough, and progressive dyspnea, and were diagnosed and eventually cured by bronchoscopy.

Conclusions: Plastic bronchitis is a rare, variable and potentially fatal disease. In the cases we described, the cause was associated with adenovirus serotype 7 and its treatment required intervention with bronchoscopy and adequate control of the underlying disease.

Keywords: Adenovirus; Bronchoscopy; Children; Plastic bronchitis.

Fig. 1

Chest X-ray of patient 1 at admission: atelectasis in the left lower lung

Fig. 2

Cast removed from left lower lobe bronchus of patient 1

Fig. 3

The cast was composed of inflammatory necrosis and neutrophils

Fig. 4

After treatment:the left lower lobe consolidation was significantly absorbed

Fig. 5

Chest X-ray of patient 2 atelectasis in the left lower lung

Fig. 6

Cast removed from left inferior lobar bronchus of patient 2

Fig. 7

The cast was composed of a large quantity of inflammatory necrosis and neutrophils and a small number of lymphocytes

Fig. 8

After bronchoscopy, a follow-up chest radiograph:the left lower lobe consolidation was significantly absorbed