title: Add-on treatment with nebulized hypertonic saline in a child with plastic bronchitis after the Glenn procedure.
abstract: Plastic bronchitis (PB), although a rare cause of airway obstruction, has mortality rates up to 50% in children after Fontan-type cardiac surgery. We present the case of an 18-month-old female patient with PB following pneumonia. At 6 months of age, the patient underwent the Glenn procedure due to functionally univentricular heart. Fiberoptic bronchoscopy revealed complete blockage of the left bronchus by mucoid casts. Pharmacotherapy consisted of glucocorticosteroids, azithromycin, and enalapril maleate. The child also received nebulized 3% NaCl solution, which proved to be beneficial. In children submitted to Fontan-type procedures, physicians must be alert for PB, which can be triggered by respiratory tract infection.
authors.affiliation: Jagiellonian University, Medical College, Department of Pediatrics, Chair of Pediatrics, Cracow, Poland, Professor. Department of Pediatrics, Chair of Pediatrics, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Lis
authors.affiliation: Jagiellonian University, Medical College, Department of Pediatrics, Chair of Pediatrics, Cracow, Poland, Associated Professor. Department of Pediatrics, Chair of Pediatrics, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Cichocka-Jarosz
authors.affiliation: Jagiellonian University, Medical College, Department of Pediatrics, Chair of Pediatrics, Cracow, Poland, Associated Professor. Department of Pediatrics, Chair of Pediatrics, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Urszula
authors.initials: U
authors.lastname: Jedynak-Wasowicz
authors.affiliation: Jagiellonian University, Medical College, Department of Pediatrics, Chair of Pediatrics, Cracow, Poland, Assistant. Department of Pediatrics, Chair of Pediatrics, Jagiellonian University Medical College, Cracow, Poland.
authors.forename: Edyta
authors.initials: E
authors.lastname: Glowacka
mesh_terms: D017963:Azithromycin / Q000008:administration & dosage; D001991:Bronchitis / Q000188:drug therapy* / Q000209:etiology*; D004359:Drug Therapy, Combination; D004656:Enalapril / Q000008:administration & dosage; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects*; D005938:Glucocorticoids / Q000008:administration & dosage; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D007223:Infant; D009330:Nebulizers and Vaporizers; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*
chemical_list: D005938:Glucocorticoids; D012462:Saline Solution, Hypertonic; D004656:Enalapril; D017963:Azithromycin