Plastic bronchitis (pseudomembranous bronchitis, fibrinous bronchitis, bronchial croup) is rare. Characteristic is the coughing of a sick child with fibrinous casts, reminiscent of the structure of the bronchial tree. Microscopy of casts reveals fibrin, mucus, lymphocytes, eosinophils, plasma cells and banal coccal flora. The presence of eosinophils in the casts of the bronchi, Shar-Ko-Leiden crystals, and Kurshman spirals was the basis to consider this disease as a manifestation of an allergy.
The etiology of the disease is not clear. They allow the possibility of developing primary chronic idiopathic plastic bronchitis and its occurrence as a secondary disease in various bronchopulmonary pathologies (tuberculosis, bronchiectasis, bronchial asthma, etc.).
In addition to coughing bronchial casts, patients have a cough, mainly paroxysmal, shortness of breath, pain and discomfort in the chest. The severity of these symptoms is determined by the extent of the lesion of the obstructed bronchial tree. This also determines the prevalence of atelectasis, which is one of the constant and characteristic symptoms of plastic bronchitis.
The course of the disease can be acute or relapsing. The intervals between relapses are different (from several days to several years). There are cases of a single manifestation of the disease, without relapse in the future.
In the acute period of the disease, dense white or gray masses are completely obstructed in their lumen in the main and lobar bronchi of the affected side. The prognosis for plastic bronchitis is mostly favorable. After isolation of the cast of bronchi, atelectasis is straightened.
In the period of exacerbation, agents are used that help dilute the bronchial contents. The main method of treatment is bronchoscopy, which allows using bronchoscopic forceps to remove fibrinous deposits that are tightly soldered to the bronchial wall. Antibiotics are indicated.