Abstract
A 60-year-old woman suddenly became nearly asphyxiated. She was intubated orally, but it was too difficult to ventilate her manually. Bronchofibroscopy revealed airway obstruction by foreign matter, but it was too difficult to remove with forceps. Emergency tracheostomy was then performed, and after removal with forceps, the patient recovered dramatically. The matter was determined to consist of pseudomembranes histologically, and Staphylococcus aureus was detected in a bronchial biopsy specimen. Based on these findings a diagnosis of necrotizing tracheobronchitis (NTB) was made. NTB is not a very common disease, especially in adults. Sloughing of pseudomembranes may occur in NTB, however, and cause paroxysmal dyspnea or asphyxia. In such cases, not only should intubation be attempted but bronchofibroscopy and, if necessary, immediate tracheostomy.
