Bronchiectasis with Transmediastinal Herniation of the Left Upper Lobe in a 3-Year-Old Child: A Case Report

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Keywords:

Tuberculosis, Pulmonary medicine, Pediatrics

Abstract

Background: Bronchiectasis is a disorder marked by the destruction of smooth muscle and elastic tissue caused by inflammation, resulting in the permanent expansion of bronchi and bronchioles. It can occur following a single severe episode or repeated episodes of pneumonia, as well as exposure to tuberculosis.

The Case: A child reported with cough and cold for 7 days, with mild fever. He was admitted to the hospital due to breathing difficulties and facial swelling. The clinical exam showed crepitation, wheezing, and pectus carinatum. Patient has history of multiple hospital admissions due to pneumonia and respiratory distress and exposure to tuberculosis. His mother was diagnosed and treated for tuberculosis when he was 3 months old. Condition of the patient was evaluated using ultrasonographic examination, chest radiograph and High-Resolution Computed Tomography of thorax.

Conclusion: High-resolution Computed Tomography (HRCT) scanning is the preferred diagnostic test as it helps to identify the pathologic changes and the exact extent through which it has taken place. Early intervention plays a critical role in reducing severe complications like hemoptysis and cor pulmonale. The current treatment options consist of antibiotics, bronchodilators, anti-inflammatory medications, and physical therapy. The patient was treated using steroids, anti-microbials and inhalational bronchodilators. Complete symptom resolution was noted in two weeks from date of admission. He also seemed to be doing well in the follow-up visit, one week post discharge. Severe cases may require injectable antibiotics. As a widespread condition in India, early diagnosis and treatment with suitable antimicrobials is critical for a positive outcome.

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References

Koul PA, Dhar R. 'World Bronchiectasis Day': The Indian perspective. Lung India. 2022;39(4):313-314.

Flume PA, Chalmers JD, Olivier KN. Advances in bronchiectasis: endotyping, genetics, microbiome, and disease heterogeneity. Lancet. 2018 Sep 8;392(10150):880-890.

Kumar V, Abbas AK, Aster JC, Perkins JA. Robbins & Cotran Pathologic Basis of Disease. 10th ed. Philadelphia: Elsevier; 2021.

World Health Organization. Weight- for-age. Available from: https://www.who.int/tools/child-growth-standards/standards/weight-for-age. Last updated Apr 26, 2024; Cited: Oct 26, 2024.

Amati F, Simonetta E, Gramegna A, Tarsia P, Contarini M, Blasi F, et al. The biology of pulmonary exacerbations in bronchiectasis. Eur Respir Rev. 2019;28(154):190055.

Goyal V, Chang AB. Bronchiectasis in Childhood. Clin Chest Med. 2022;43(1):71-88.

Hariprasad K, Krishnan S, Mehta RM. Bronchiectasis in India: Results from the EMBARC and Respiratory Research Network of India Registry. Natl Med J India. 2020;33(2):99-101.

Imam JS, Duarte AG. Non-CF bronchiectasis: Orphan disease no longer. Respir Med. 2020;166:105940.

Wilkinson I. Oxford Handbook of Clinical Medicine. 10th ed. Oxford: Oxford University Press; 2017.

Chapman S. Oxford Handbook of Respiratory Medicine. 4th ed. Oxford: Oxford University Press; 2021.

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Published

2024-11-20

How to Cite

Dasgupta, A., & Raychaudhuri, D. (2024). Bronchiectasis with Transmediastinal Herniation of the Left Upper Lobe in a 3-Year-Old Child: A Case Report. International Journal of Medical Students. Retrieved from https://ijms.pitt.edu/IJMS/article/view/2176

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Copyright (c) 2024 Anuva Dasgupta, Dibyendu Raychaudhuri

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