title: Closure of a bronchopleural fistula with bronchoscopic instillation of tetracycline.
abstract: Persistent bronchopleural fistulas (BPF) due to infection, trauma, or thoracic surgical procedures are often difficult to manage. We report a patient with fulminant Staphylococcus aureus pneumonia complicated by chronic BPF formation which prevented weaning from mechanical ventilation due to severe air leak. Fistula closure was obtained by instillation of tetracycline into the fistula via a fiberoptic bronchoscope using a balloon catheter and blood clot occlusion technique. This closed the BPF and allowed successful weaning from mechanical ventilation.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California Davis Medical Center, Sacramento.
authors.forename: W R
authors.initials: WR
authors.lastname: Martin
authors.forename: A D
authors.initials: AD
authors.lastname: Siefkin
authors.forename: R
authors.initials: R
authors.lastname: Allen
mesh_terms: D000293:Adolescent; D001983:Bronchial Fistula / Q000209:etiology / Q000628:therapy*; D001999:Bronchoscopy; D005402:Fistula / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007322:Instillation, Drug; D008297:Male; D010995:Pleural Diseases / Q000209:etiology / Q000628:therapy*; D011023:Pneumonia, Staphylococcal / Q000150:complications; D015911:Sclerotherapy; D013752:Tetracycline / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D013752:Tetracycline