We report a case of a 70-year-old woman who presented with mild exertional dyspnea and cough. Fiberoptic bronchoscopic findings revealed an endobronchial polypoid lesion with stenotic bronchus. The lesion was very similar to endobronchial tuberculosis. Histologic examination of the biopsy specimen demonstrated Actinomyces infection. There was a clinical response to intravenous penicillin therapy. Primary endobronchial actinomycosis must be considered in the differential diagnosis of an endobronchial lesion, especially endobronchial tuberculosis in Korea.
Actinomycosis/pathology* ; Actinomycosis/microbiology ; Actinomycosis/diagnosis ; Aged ; Bronchial Diseases/pathology* ; Bronchial Diseases/microbiology ; Bronchial Diseases/diagnosis ; Case Report ; Diagnosis, Differential ; Female ; Human ; Tomography, X-Ray Computed/methods ; Tuberculosis, Pulmonary/pathology* ; Tuberculosis, Pulmonary/diagnosis

OBJECTIVETo assess the efficacy and safety of balloon dilatation through flexible bronchoscopy in the management of inflammatory stenosis of grade 4-5 bronchus.

METHODThirty patients with inflammatory bronchial stenosis caused by mycoplasmal pneumonia complicated with pulmonary atelectasis were treated with balloon dilatation through fiberoptic bronchoscopy. Before the procedure and after the last operation, therapeutic effect on pulmonary atelectasis were evaluated with CT and all of the patients were followed-up for 1 - 6 months.

RESULTOne to three operations were required to achieve satisfactory dilatation. After balloon dilatation, the average airway diameter increased obviously and the farther airways were opened after the therapy with irrigation. In 25 of 30 cases satisfactory immediate effects were obtained, a narrow airway diameter above expansion significantly increased as compared with preoperative diameter. In 5 children treated with balloon dilatation, the stenosis could not be improved significantly. In 3 patients with hyperplasia of granulation tissue, cryotherapy had to be applied. The operations were ineffective in the other two patients whose course of disease exceeded 3 months. After follow-up periods of 1 - 6 months, chest CT manifestation of expanded sites was improved in 28 patients and atelectasis disappeared. No severe complication was found in any patients.

CONCLUSIONBronchoplasty by balloon dilatation through flexible fiberoptic bronchoscopy is a simple, effective and safe method to treat childhood tracheobronchial stenosis after pulmonary infections.

Bronchial Diseases ; therapy ; Bronchoscopy ; Catheterization ; methods ; Child ; Child, Preschool ; Female ; Humans ; Male ; Pneumonia, Mycoplasma ; therapy ; Pulmonary Atelectasis ; microbiology ; therapy ; Tracheal Stenosis

Mycobacterium avium complex (MAC) infection is a common opportunistic infection in patients with AIDS (acquired immune deficiency syndrome). Pulmonary involvement of MAC may range from asymptomatic colonization of the respiratory tract to invasive parenchymal or cavitary disease. However, endobronchial lesions with MAC infection are rare in immunocompetent and immunosuppressed hosts. Here, we report MAC infection presenting as an endobronchial mass in a patient with AIDS.
Acquired Immunodeficiency Syndrome/*complications ; Adult ; Antitubercular Agents/therapeutic use ; Bronchial Diseases/complications/diagnosis/drug therapy/*microbiology ; Bronchoscopy ; Humans ; Male ; Mycobacterium avium Complex ; Mycobacterium avium-intracellulare Infection/complications/*diagnosis/drug therapy ; Opportunistic Infections/*complications/diagnosis/drug therapy ; Tomography, X-Ray Computed