Quentin Christine, Lefevre Nicolas, Bodart Eddy, Hanssens Laurence
a Department of Pneumology , Hopital Universitaire des Enfants Reine Fabiola- Universite Libre de Bruxelles (ULB) , Brussels , Belgium.
b Department of Paediatrics CHU Dinant Godinne , Namur-Université catholique de Louvain (UCL) , Yvoir , Belgium.
Acta Clin Belg. 2018 Jun;73(3):233-235. doi: 10.1080/17843286.2017.1373498. Epub 2017 Sep 11.
Objective and importance Mounier Kuhn syndrome is usually diagnosed in adulthood, and only a few cases have been described in childhood. Clinical presentation We present the case of a seven-year-old boy suffering from recurrent pneumonia and atelectasis. Intervention Previously performed chest X-rays showed bilateral hyperinflation and tracheobronchomegaly. Chest computed tomography (CT) confirmed the presence of distal enlargement of trachea and bronchi. Tracheobronchomegaly associated with recurrent respiratory tract infections is consistent with Mounier Kuhn syndrome. Pseudomonas aeruginosa was isolated from the sputum of the patient. He was then treated according to the guidelines for P. aeruginosa management in cystic fibrosis patients considering the similarities in clinical presentations and pathophysiology of both diseases. Antibiotic treatment resulted in a remarkable reduction of events of pulmonary exacerbation and hospitalizations. There are no specific guidelines for treatment options in case of pulmonary exacerbation of Mounier Kuhn syndrome. Case reports discussing the choice and efficiency of antibiotic treatment are random. Conclusion headings We share our experience of treating pulmonary exacerbation caused by P. aeruginosa in a patient with Mounier Kuhn syndrome suggesting a possible treatment option of pseudomonas infections in this syndrome.
穆尼尔-库恩综合征通常在成年期被诊断出来,儿童期仅有少数病例报道。临床表现:我们报告一例7岁男孩反复发生肺炎和肺不张的病例。干预措施:此前的胸部X线片显示双侧肺过度充气以及气管支气管扩张。胸部计算机断层扫描(CT)确认存在气管和支气管远端扩张。与反复呼吸道感染相关的气管支气管扩张符合穆尼尔-库恩综合征。从患者痰液中分离出铜绿假单胞菌。鉴于两种疾病在临床表现和病理生理学上的相似性,随后按照囊性纤维化患者铜绿假单胞菌管理指南对他进行治疗。抗生素治疗使肺部加重事件和住院次数显著减少。对于穆尼尔-库恩综合征肺部加重的治疗选择尚无具体指南。讨论抗生素治疗选择和疗效的病例报告是随机的。结论:我们分享了治疗穆尼尔-库恩综合征患者由铜绿假单胞菌引起的肺部加重的经验,提示了该综合征中假单胞菌感染可能的治疗选择。