title: Broncholithiasis presenting as bronchiectasis and recurrent pneumonias.
abstract: A broncholith is defined as the presence of calcified material within a bronchus or within a cavity communicating with a bronchus. It is most frequently caused by Histoplasmosis or tuberculosis (TB) spp. Bronchial distortion, irritation and erosion by broncholiths can cause bronchiectasis, recurrent pneumonias and haemoptysis. We present a case of recurrent pneumonia due to a broncholith, which resolved conservatively with antibiotics. Owing to recurrent fevers and post obstructive pneumonias, a lobectomy or rigid bronchoscopic removal were considered but the patient was deemed not to be a candidate for general anaesthesia due to her comorbidities. Broncholiths are an uncommon cause of bronchiectasis and recurrent pneumonias. However, the wide range of symptoms and low clinical suspicion are the main reasons why a diagnosis can be delayed. Various treatment options are available and the choice of therapy should be made depending on the broncholith's size, mobility, location and local surgical expertise.
authors.affiliation: Department of Internal Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Dakkak
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida, USA.
authors.forename: Furqan
authors.initials: F
authors.lastname: Siddiqi
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida, USA.
authors.forename: James Davis
authors.initials: JD
authors.lastname: Cury
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001982:Bronchial Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D001987:Bronchiectasis / Q000209:etiology*; D018893:Bronchoalveolar Lavage; D002637:Chest Pain / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D020347:Lithiasis / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D008875:Middle Aged; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use; D000077725:Piperacillin, Tazobactam Drug Combination; D011014:Pneumonia / Q000209:etiology*; D012008:Recurrence; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000077725:Piperacillin, Tazobactam Drug Combination; D014640:Vancomycin; D010397:Penicillanic Acid; D010878:Piperacillin