Bongaerts Dries, Wojciechowski Marek, Suys Bert, Luijks Marloes, Van Marck Eric, Jorens Philippe G
Departments of Anesthesiology, Antwerp University Hospital, University of Antwerp, Belgium.
J Asthma. 2009 Aug;46(6):586-90. doi: 10.1080/02770900902915854.
Here we present the case of a 5-year-old boy who experienced a prehospital cardiac arrest after a period of wheezing, upper respiratory tract infection, and diarrhea. After successful resuscitation, ventilation was initially extremely difficult for no obvious reason. Various bronchodilatatory therapies were started with only limited result. Diagnosis of plastic bronchitis was made after bronchoscopy and at autopsy when therapy was withdrawn in view of the absence of cerebral circulation. A thickened basal membrane, a specific hallmark of asthma, was also present. Cardiac arrest in plastic bronchitis due to inflammatory and allergic disease is very rare. Pathological examination of the cast showed a mucinous cast with neutrophilic granulocytes, which is also seldom seen. This case illustrates that the diagnosis of plastic bronchitis can be extremely difficult if only minor respiratory symptoms occur. This resulted in a delayed diagnosis and fatal outcome.
在此，我们报告一名5岁男童的病例，该男童在经历一段时间的喘息、上呼吸道感染和腹泻后，在院前发生心脏骤停。成功复苏后，起初通气异常困难，原因不明。启动了各种支气管扩张治疗，但效果有限。在支气管镜检查后诊断为塑形性支气管炎，鉴于脑循环停止而停止治疗后，尸检时也确诊为该病。同时还存在哮喘的一个特异性标志——基底膜增厚。炎症和过敏性疾病导致的塑形性支气管炎引发心脏骤停非常罕见。铸型的病理检查显示为含有中性粒细胞的黏液铸型，这也很少见。该病例表明，如果仅出现轻微的呼吸道症状，塑形性支气管炎的诊断可能极其困难。这导致了诊断延迟和致命后果。
