A Case of Effective Treatment for Plastic Bronchitis by Laryngeal Mask Airway Control

Abstract

Background. Plastic bronchitis is sometimes associated with influenza viral infection in children, especially in those who have a history of bronchial asthma. Case. An 8-year-old boy with a history of bronchial asthma complained of cough and wheezes, and was admitted to a clinic after dyspnea and chest pain developed. An asthma attack and pneumonia were diagnosed and he was hospitalized. Despite the administration of antibiotics, steroids and a bronchodilator, acute respiratory failure developed due to complete atelectasis of the right lung. After transferral to our hospital, the bronchoscopic removal of mucus impaction was performed under general anesthesia by laryngeal mask ventilation. The right bronchial tree was completely occluded by a massive mucus plug. The airway was cleared following suction extraction of the mucus through a bronchofiberscope, and a laryngeal mask was exchanged for an endotracheal tube for adequate positive pressure ventilation. He was discharged 9 days after the intervention. Pathologically, an influenza virus was detected in the removed mucus plug. Conclusion. We effectively and safely treated a case of severe plastic bronchitis by tactical airway control.