Pseudomembranous Tracheobronchitis With Severe Tracheal Stenosis and Masked Bronchial Obstruction

Radiation-induced pseudomembranous tracheobronchitis: A report of two cases

Radiation therapy can cause radiation pneumonitis, organizing pneumonia, and lung fibrosis. Radiation‐induced pseudomembranous bronchitis is a rare condition. Here, we describe a rare case each of pseudomembranous tracheobronchitis and pseudomembrane with total bronchial obstruction which developed after thoracic radiotherapy. A 50‐year‐old man presented paroxysmal severe cough 1 month after concurrent chemoradiotherapy for small‐cell lung cancer. Bronchoscopy revealed a whitish membrane in the trachea and bronchus, which were the fields of radiation. Another 60‐year‐old man complained of dyspnea 7 months after radiation therapy for metastatic lymph node adenocarcinoma. Bronchoscopy demonstrated a membrane with total obstruction of right lower lobar bronchus, which was the area of radiation. The pathological findings of histological examination in both cases demonstrated radiation‐induced pseudomembranous tracheobronchitis. Patients in both cases responded well to steroids and the pseudomembrane disappeared. If patients who have received thoracic radiation therapy complain of persistent cough, bronchoscopy may be helpful.

Obstructive fibrinous pseudomembrane tracheitis after double lumen tube intubation: a case report

Background

Obstructive fibrinous pseudomembrane tracheitis (OFPT) is a rare complication of endotracheal intubation.

Case

We describe the case of a 73-year-old woman who underwent short-term intubation for video-assisted thoracoscopic surgery and developed an acute life-threatening stridor two days after extubation. The patient required an emergency tracheostomy to maintain airway patency and a microscopic direct laryngoscopy procedure was performed thereafter with removal of the obstructive pseudomembrane. Subsequently, the patient also suffered a non-ST-elevation myocardial infarction. The patient successfully recovered, and the tracheostomy was subsequently decannulated two months later. Histological examination revealed mucosal ulcerations and inflammatory changes.

Conclusions

OFPT is an uncommon cause of life-threatening airway obstruction after extubation that is not often recognized immediately but can usually be treated with early bronchoscopic intervention or microscopic direct laryngoscopy.