Thoracic air leakage in the presentation of cast bronchitis.
BACKGROUND
Cast bronchitis is a rare but potentially fatal condition caused by the accumulation of mucus in the bronchial tree usually secondary to infection, inflammation, or vascular stasis. Air leakage is an uncommon presentation of cast bronchitis. We report on three children with cast bronchitis who presented with acute air leakage as the main clinical feature.


METHODS
All three patients underwent bronchoscopic evaluation that led to a diagnosis and removal of bronchial casts.


RESULTS
Pathologic examination of casts from all three patients showed a mucoid substance with eosinophilic infiltration. The outcome for all patients was favorable.


CONCLUSIONS
Acute respiratory failure presenting with wheezing and thoracic air leakage refractory to standard asthma therapy should raise suspicion of cast bronchitis, and urgent bronchoscopy should be performed.
Kruger
Jonah
J
Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, Israel. Electronic address: jonahkruger@hotmail.com.
Shpringer
Chaim
C
Pulmonology Institute, Hadassah-Hebrew University Medical Center, Ein Kerem, Israel.
Picard
Elie
E
Department of Pediatric Pulmonology, Shaare Zedek Medical Center, Jerusalem, Israel.
Kerem
Eitan
E
Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, Israel.
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D001991:Bronchitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D001999:Bronchoscopy; D002675:Child, Preschool; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D009093:Mucus / Q000378:metabolism*; D013902:Radiography, Thoracic; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones