Plastic bronchitis: an unusual cause of respiratory distress in children.

This case illustrates an unusual cause of respiratory distress in the pediatric population. A high degree of suspicion is necessary to make the diagnosis of plastic bronchitis. Wheezing and cough will lead to the diagnosis of reactive airway disease and/or foreign body aspiration. Chest radiographs may yield additional information, but the diagnosis is made by bronchoscopy and removal of the casts. Any child with severe respiratory distress refractory to aggressive conventional medical therapy and with a history or radiograph suggestive of plastic bronchitis should be considered a candidate for bronchoscopy. As clinicians, we must always remember the dictum, "All that wheezes is not asthma."