关键词: Anatomopathologie Bronchial mould Histopathology Moule bronchique Pulmonary tuberculosis Tuberculose pulmonaire

Mesh : Adult Anti-Bacterial Agents / therapeutic use Bronchi / microbiology pathology Bronchitis / diagnosis drug therapy etiology Bronchoscopy / methods Diagnosis, Differential Empyema, Pleural / drug therapy etiology Glucocorticoids / therapeutic use Humans Male Sputum / microbiology Tomography, X-Ray Computed Tuberculosis, Pulmonary / complications drug therapy

来  源:   DOI:10.1016/j.rmr.2018.02.013   PDF(Sci-hub)

Abstract:
BACKGROUND: Bronchial mould infection or plastic bronchitis is a rare condition, encountered at any age, but with a predilection for childhood. The clinical diagnosis is made easy by the demonstration of solid, branched expectorations. However, the aetiology is not easy to determine and investigation does not often lead to a pathological diagnosis.
METHODS: We report the case of a 24 year-old patient, with a history of pulmonary tuberculosis in January 2016, who had had chronic, persistent, solid and branched expectorations since January 2015. Fibreoptic bronchoscopy revealed thick white secretions plugging the bronchi. Pathological examination of the bronchial plugs showed fibrous tissue infiltrated with predominantly lymphoplasmocytic and histiocytic inflammatory cells. Investigations carried out on the pleura did not establish the aetiological diagnosis. The diagnosis of bronchial mould disease of tuberculous origin complicated by pleurisy was established. Corticosteroid therapy led to a complete regression of the moulds within six weeks.
CONCLUSIONS: The presence of solid and branched sputum should suggest fungal bronchitis and is an indication for bronchoscopy for diagnostic and therapeutic purposes. Early management is important to avoid complications.
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