Plastic bronchitis in a 5-year-old boy causing asystoly and fatal outcome.
Here we present the case of a 5-year-old boy who experienced a prehospital cardiac arrest after a period of wheezing, upper respiratory tract infection, and diarrhea. After successful resuscitation, ventilation was initially extremely difficult for no obvious reason. Various bronchodilatatory therapies were started with only limited result. Diagnosis of plastic bronchitis was made after bronchoscopy and at autopsy when therapy was withdrawn in view of the absence of cerebral circulation. A thickened basal membrane, a specific hallmark of asthma, was also present. Cardiac arrest in plastic bronchitis due to inflammatory and allergic disease is very rare. Pathological examination of the cast showed a mucinous cast with neutrophilic granulocytes, which is also seldom seen. This case illustrates that the diagnosis of plastic bronchitis can be extremely difficult if only minor respiratory symptoms occur. This resulted in a delayed diagnosis and fatal outcome.
Bongaerts
Dries
D
Departments of Anesthesiology, Antwerp University Hospital, University of Antwerp, Belgium.
Wojciechowski
Marek
M
Suys
Bert
B
Luijks
Marloes
M
Van Marck
Eric
E
Jorens
Philippe G
PG
D001991:Bronchitis / Q000150:complications* / Q000473:pathology*; D001999:Bronchoscopy; D002675:Child, Preschool; D017809:Fatal Outcome; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D012120:Respiration Disorders / Q000209:etiology