title: Bronchial tree-shaped mucous plug in cystic fibrosis: imaging-guided management.
abstract: We report the case of a 17-year-old boy with cystic fibrosis (CF) who presented with persistent cough; after starting intravenous antibiotics forPseudomonas aeruginosahe underwent a computed tomography (CT) scan of the chest. CT revealed extensive consolidation in the right lower lobe with relative bronchus obstruction; the cause of bronchial obstruction was detected in the mediastinal window, corresponding to a bronchial tree-shaped, thick, tenacious mucous plug. This was extracted 48 h after unresponsive bronchial washing and endobronchial instillation of rhDNAse, using foreign-body forceps, with subsequent resolution of cough. This case, which is the second report of plastic bronchitis in CF, was resolved by mechanical removal of the mucous plug, suggesting that a careful observation of CT imaging may guide intervention aimed at resolution of atelectasis.
authors.affiliation: Oncological Radiology Unit, Department of Biomedical and Dental Sciences and Morphofunctional Imaging Policlinico G. Martino Hospital - University of Messina Messina Italy.
authors.forename: Ignazio
authors.initials: I
authors.lastname: Salamone
authors.affiliation: Thoracic Surgery Unit, Thorax, Heart and Vascular Department Policlinico G. Martino Hospital - University of Messina Messina Italy.
authors.forename: Baldassare
authors.initials: B
authors.lastname: Mondello
authors.affiliation: Cystic Fibrosis Center, Mother-Child Department Policlinico G. Martino Hospital - University of Messina Messina Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Lucanto
authors.affiliation: Cystic Fibrosis Center, Mother-Child Department Policlinico G. Martino Hospital - University of Messina Messina Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Cristadoro
authors.affiliation: Cystic Fibrosis Center, Mother-Child Department Policlinico G. Martino Hospital - University of Messina Messina Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Lombardo
authors.affiliation: Thoracic Surgery Unit, Thorax, Heart and Vascular Department Policlinico G. Martino Hospital - University of Messina Messina Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Barone
keywords: Atelectasis; DNAse; cystic fibrosis; imaging; plug