1/12. Aspergillus laryngotracheobronchial infection in a 6-year-old girl following bone marrow transplantation.Localised fungal infection of the larynx and tracheobronchial tree is extremely uncommon. We report the case of a 6-year-old girl with acute lymphocytic leukaemia, who developed symptoms of upper airways obstruction 6 months after a cord blood transplant. bronchoscopy showed a pale plaque lesion in the larynx and tracheobronchial tree. aspergillus fumigatus was cultured from a biopsy of the lesion. The patient was treated successfully with a prolonged course of amphotericin b and assessed with multiple surveillance bronchoscopies.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/12. Aspergillus bronchitis causing atelectasis and acute respiratory failure in an immunocompromised patient.Aspergillus tracheobronchitis is an uncommon clinical form of invasive aspergillosis with fungal infection limited entirely or predominantly to the tracheobronchial tree. We report a case of aspergillus fumigatus bronchitis, diagnosed by fiberoptic bronchoscopy, with fungal growth completely occluding the left main bronchus leading to lung collapse and acute respiratory failure in a 60-year-old male with erythroleukemia and profound granulocytopenia.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
3/12. Treatment of plastic bronchitis in a Fontan patient with tissue plasminogen activator: a case report and review of the literature.Plastic bronchitis is a condition in which large, bronchial casts with rubber-like consistency develop in the tracheobronchial tree and cause airway obstruction. We describe a 4-year-old girl who had Fontan physiology and who developed plastic bronchitis and report for the first time the use of aerosolized tissue plasminogen activator for treatment of this condition. The literature is reviewed with emphasis placed on the occurrence of this disorder in patients with single ventricle physiology.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
4/12. Treatment of cast bronchitis with low-dose oral azithromycin.Cast or plastic bronchitis is an unusual disorder that is rarely encountered in the pediatric population. It is characterized by the expectoration of large, branching plugs of airway debris. These "casts" conform to the shape of portions of the tracheobronchial tree, and give the disorder its name. Cast bronchitis is typically seen in association with several primary pulmonary disorders and cyanotic congenital heart disease. It can be classified as inflammatory or acellular, based on the histologic characteristics of the casts. The presence of large, obstructive plugs filling the airways of lobes or entire lungs can result in a variety of clinical signs and symptoms, and may ultimately lead to respiratory failure and death. Conventional treatment of cast bronchitis has focused on the clearance of obstructing material from the airways combined with therapy for any underlying cardiopulmonary disease. Unfortunately, this approach has not proven very effective, and patient mortality remains high.We report on a case in which a patient with cast bronchitis was treated with long-term, low-dose oral azithromycin. This therapy resulted in clinical, spirometric, and radiographic improvement of the patient.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
5/12. Treatment of plastic bronchitis in acute chest syndrome of sickle cell disease with intratracheal rhDNase.Plastic bronchitis, a condition associated with widespread mucous plugging of the tracheobronchial tree, is an increasingly recognised bronchoscopic finding in acute chest syndrome of sickle cell disease. Removal of casts by bronchoscopy is technically challenging. We describe a child with acute chest syndrome where bronchoscopic removal of extensive tracheobronchial plastic casts was facilitated by intratracheal rhDNase.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
6/12. Plastic bronchitis; a serious complication of the Fontan operation.Plastic bronchitis is characterised by the formation of large bronchial casts, which develop in the tracheobronchial tree and can cause airway obstruction. It has been increasingly encountered in more recent years as a serious complication of the Fontan operation with a reported mortality of up to 50% [Am. J. Respir. Crit. Care Med. 155 (1997) 364]. We report a case of a 4-year-old girl with Fontan circulation who developed plastic bronchitis and was successfully treated.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
7/12. Congenital bronchial atresia (CBA). A critical review of CBA as a disease entity and presentation of a case series.PURPOSE: To analyse the state of the art of diagnostic imaging in the rare disease entity known as congenital bronchial atresia (CBA) and to suggest new guidelines for diagnosis. MATERIALS AND methods: From January 2002 to December 2003 we examined 6 patients, 4 males and 2 females. Four of them complained of relapsing bronchitis; one patient was admitted with a diagnosis of pulmonary abscess. All patients underwent chest X-ray and MDCT. RESULTS: Five patients presented at chest x-ray the typical association of hilar mass and distal parenchymal hyperinflation that raised the suspicion of CBA; the remaining patient presented an area of parenchymal translucency that prompted us to perform MDCT, which showed severe stenosis of the segmental bronchus. CBA involved the left upper lobe (LUL) in 4 patients and the right upper lobe (RUL) in the remaining 2. In 50% of cases there were associated anomalies: distal bronchiectasis, bronchogenic cyst, anomaly of branching of bronchial tree and vascular structure. CONCLUSIONS: CBA is a relatively rare, generally oligosymptomatic malformation. knowledge of the signs present at chest X-ray can prompt the radiologist to perform a CT scan. MDCT with multiplanar reconstruction is fundamental for the characterisation, localisation and study of the distribution of the lesion, helping to make a precise diagnosis. Surgery is seldom required and at any rate only performed in case of complications.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
8/12. Fungal tracheobronchitis. Report of 9 cases and review of the literature.Clinical, roentgenographic and pathologic findings are described in 9 patients with fungal tracheobronchitis and comparison is made with 25 additional cases in the literature. Two morphologic patterns were identified: the first appears as a pseudomembrane of necrotic tissue, exudate, and fungal hyphae involving more-or-less the entire circumference of the bronchial wall or as mucus/fungus plugs completely occluding the airway lumen; the second consists of single or multiple discrete plaques on the airway wall, sometimes associated with invasion of the adjacent lung parenchyma or pulmonary artery. As with more invasive forms of fungal infection, a compromise in host defenses is probably the most important factor leading to fungal colonization and subsequent local invasion. Malignancies of the hematologic and lymphoreticular systems, solid neoplasms, granulocytopenia, and a history of a protracted course of broad-spectrum antibiotics, corticosteroids, and chemotherapy were present in most of our patients and in those reported in the literature. Despite this, there is some evidence that tracheobronchitis may occur in individuals with a relatively lesser degree of host defense impairment. Local damage to the airway wall such as occurs with prolonged mechanical ventilatory support, neoplastic infiltration, or nonfungal infection may also be a factor predisposing to fungal colonization and invasion. In 4 of our patients, the fungal infection of the tracheobronchial tree probably contributed significantly to the development of terminal respiratory failure. Although recognition of the infection may not have altered the course of the underlying disease in some of our patients, in others identification and early treatment might have been life-saving. Thus, culture and histologic examination of bronchoscopically identified tracheobronchial mucus plugs and necrotic material should be performed in all immunocompromised individuals.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
9/12. Necrotizing tracheobronchitis: complication of mechanical ventilation in an adult.A 51-year-old woman had localized interstitial pneumonia that rapidly progressed to involve all lung fields. After 9 days of conventional mechanical ventilation, pneumothorax developed in the presence of an obstruction of the right main bronchus. bronchoscopy and endobronchial biopsies revealed NTB involving the tracheobronchial tree distal to the tip of the endotracheal tube, with complete obstruction of the right main bronchus by hard, eschar-like material. Tracheal mucosa proximal to the tip of the endotracheal tube was normal. Subsequent bronchoscopy, 20 days later, showed marked resolution of NTB. Though a frequent complication of mechanical ventilation in the neonate, NTB as a complication of conventional mechanical ventilation has not previously been recognized in an adult. Necrotizing tracheobronchitis should be suspected in adults who have had mechanical ventilation and who are experiencing ventilatory difficulties, after routine problems have been treated or excluded.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
10/12. Pseudomembranous tracheobronchitis caused by Aspergillus.Four immunosuppressed patients with a rapidly evolving, febrile, respiratory distress syndrome were found at autopsy to have Aspergillus pseudomembranes of their lower tracheobronchial tree. steroids, neutropenia, broad spectrum antibiotic use, and alcoholism appear to be predisposing risk factors. bronchoscopy may reveal the pathology but antemortem diagnosis is difficult because of the low yield of sputum cultures and fulminant nature of the disease.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
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