title: Infected tracheal diverticulum: a rare association with alpha-1 antitrypsin deficiency.
abstract: Tracheal diverticulum, defined as a benign outpouching of the tracheal wall, is rarely diagnosed in clinical practice. It can be congenital or acquired in origin, and most cases are asymptomatic, typically being diagnosed postmortem. We report a case of a 69-year-old woman who was hospitalized after presenting with fever, fatigue, pleuritic chest pain, and a right neck mass complicated by dysphagia. Her medical history was significant: pulmonary emphysema (alpha-1 antitrypsin deficiency); bronchiectasis; and thyroidectomy. On physical examination, she presented diminished breath sounds and muffled heart sounds, with a systolic murmur. Laboratory tests revealed elevated inflammatory markers, a CT scan showed an air-filled, multilocular mass in the right tracheal wall, and magnetic resonance imaging confirmed the CT findings. Fiberoptic bronchoscopy failed to reveal any abnormalities. Nevertheless, the patient was diagnosed with tracheal diverticulum. The treatment approach was conservative, consisting mainly of antibiotics. After showing clinical improvement, the patient was discharged.
authors.affiliation: Hospital de Santa Maria, Northern Lisbon Hospital Center, Department of Internal Medicine, Lisbon, Portugal. Department of Internal Medicine, Northern Lisbon Hospital Center, Hospital de Santa Maria, Lisbon, Portugal.
authors.forename: Cecília Beatriz Alves
authors.initials: CB
authors.lastname: Amaral
authors.affiliation: Santarém Hospital, Santarém, Portugal. Santarém Hospital, Santarém, Portugal.
authors.forename: Sónia
authors.initials: S
authors.lastname: Silva
authors.affiliation: Hospital de Santa Maria, Northern Lisbon Hospital Center, Lisboa, Portugal. Northern Lisbon Hospital Center, Hospital de Santa Maria, Lisboa, Portugal.
authors.forename: Salvato
authors.initials: S
authors.lastname: Feijó
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004240:Diverticulum / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D000077731:Meropenem; D011656:Pulmonary Emphysema; D013845:Thienamycins / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014133:Tracheal Diseases / Q000150:complications* / Q000188:drug therapy; D014640:Vancomycin / Q000627:therapeutic use; D019896:alpha 1-Antitrypsin Deficiency / Q000150:complications* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D014640:Vancomycin; D000077731:Meropenem
keywords: Diverticulum; Pulmonary emphysema; Tracheal diseases; alpha 1-antitrypsin deficiency