# Refractory type 1 plastic bronchitis in a child; case report

## TL;DR

A 13-year-old boy with a rare lung condition called plastic bronchitis required a lung removal due to recurring blockages in his bronchus.

## Contribution

This case report highlights the progression and management of refractory plastic bronchitis leading to pneumonectomy in a pediatric patient.

## Key findings

- Plastic bronchitis can lead to recurrent bronchial cast formation requiring surgical intervention.
- Flexible bronchoscopy confirmed total bronchial occlusion in the patient.
- Pneumonectomy was ultimately performed due to persistent and unmanageable symptoms.

## Abstract

Plastic bronchitis (PB) is a rare pediatric pulmonary condition characterized by the production of branching bronchial casts that cause partial or total obstruction of the bronchial lumen.

We describe a 13-year-old boy with a history of bronchial asthma and left lower lobectomy, with persistent cough and left-sided chest pain when he went to the emergency room. Chest radiography showed complete left lung opacity denoting total left lung collapse, and flexible bronchoscopy revealed cohesive casts totally occluding the left bronchus, with frequent recurrence that finally ended with left pneumonectomy.

Plastic bronchitis is a rare, fatal disease in children that requires a high index of suspicion for both diagnosis and treatment. Although bronchoscopic removal of the bronchial casts together with the medical treatment are the main lines of treatment, cases with recurrent formation of casts are at high risk for surgical intervention in the form of either lobectomy or pneumonectomy.