International Journal of Medical Students (Nov 2024)
Bronchiectasis with Transmediastinal Herniation of the Left Upper Lobe in a 3-Year-Old Child: A Case Report
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.
