Thoracic air leakage in the presentation of cast bronchitis.

BACKGROUND

Cast bronchitis is a rare but potentially fatal condition caused by the accumulation of mucus in the bronchial tree usually secondary to infection, inflammation, or vascular stasis. Air leakage is an uncommon presentation of cast bronchitis. We report on three children with cast bronchitis who presented with acute air leakage as the main clinical feature.

METHODS

All three patients underwent bronchoscopic evaluation that led to a diagnosis and removal of bronchial casts.

RESULTS

Pathologic examination of casts from all three patients showed a mucoid substance with eosinophilic infiltration. The outcome for all patients was favorable.

CONCLUSIONS

Acute respiratory failure presenting with wheezing and thoracic air leakage refractory to standard asthma therapy should raise suspicion of cast bronchitis, and urgent bronchoscopy should be performed.