A Case of Congenital Bronchial Atresia Detected by Medical Checkup

Abstract

Background. Congenital bronchial atresia is a rare disease. Since advances in diagnostic imaging technologies have allowed this disease to be diagnosed without surgery, the numbers of reported cases of congenital bronchial atresia have been increasing. However, these patients are often asymptomatic, and whether or not surgical resection should be performed in asymptomatic patients with congenital bronchial atresia is unclear. Case. A 32-year-old Japanese man was found to have abnormal findings on chest X-ray at a regular medical checkup. Chest computed tomography showed cystic bronchiectasis and localized emphysematous change in the right S². He was referred to our hospital for further examination and was diagnosed with congenital bronchial atresia after several imaging examinations and bronchoscopy. Intrabronchial infection was suspected, so right upper lobe resection was performed. Purulent discharge was obtained in the cystic lesion of the resected lung, and microbial tests were conducted. The smear preparation showed Gram-negative rods, but the aerobic culture was negative. A bacterial floral analysis using the 16S ribosomal RNA gene showed numerous oral anaerobes, including Prevotella spp., and a subclinical infection in the cystic lesion of the congenital bronchial atresia was suspected. Conclusion. Surgical resection for congenital bronchial atresia may therefore occasionally be necessary when repetitive subclinical infection in the affected lesion is suspected, even if the patient is clinically asymptomatic.