Case Reports

.2021 Jan 6;21(1):2.

doi: 10.1186/s12890-020-01367-5.

Congenital bronchial atresia complicated by a lung abscess due to Aspergillus fumigatus: a case report

Gaku Kuwabara^{1 2}, Risa Sone², Waki Imoto^{1 2}, Kazushi Yamairi¹, Wataru Shibata¹, Kazuhiro Oshima¹, Koichi Yamada¹, Kazuhiro Yamada², Tetsuya Watanabe², Kazuhisa Asai², Hiroaki Komatsu³, Nobuhiro Izumi³, Noritoshi Nishiyama³, Tomoya Kawaguchi², Hiroshi Kakeya⁴

Affiliations

¹ Department of Infection Control Science, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.
² Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.
³ Department of General Thoracic Surgery, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.
⁴ Department of Infection Control Science, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan. kakeya@med.osaka-cu.ac.jp.

PMID:33407289
PMCID: PMC7788814
DOI: 10.1186/s12890-020-01367-5

Case Reports

Congenital bronchial atresia complicated by a lung abscess due to Aspergillus fumigatus: a case report

Gaku Kuwabara et al. BMC Pulm Med.2021.

.2021 Jan 6;21(1):2.

doi: 10.1186/s12890-020-01367-5.

Authors

Affiliations

¹ Department of Infection Control Science, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.
² Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.
³ Department of General Thoracic Surgery, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.
⁴ Department of Infection Control Science, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan. kakeya@med.osaka-cu.ac.jp.

PMID:33407289
PMCID: PMC7788814
DOI: 10.1186/s12890-020-01367-5

Abstract

Background: Congenital bronchial atresia is a rare pulmonary abnormality characterized by the disrupted communication between the central and the peripheral bronchus and is typically asymptomatic. Although it can be symptomatic especially when infections occur in the involved areas, fungal infections are rare complications in patients with bronchial atresia. We report a case of congenital bronchial atresia complicated by a fungal infection.

Case presentation: A 30-year-old man with no previous history of immune dysfunction was brought to a nearby hospital and diagnosed with a left lung abscess. Although antimicrobial treatment was administered, it was ineffective, and he was transferred to our hospital. Since diagnostic imaging findings and bronchoscopy suggested congenital bronchial atresia and a fungal infection, he was treated with voriconazole and surgical resection was subsequently performed. A tissue culture detected Aspergillus fumigatus and histopathological findings were compatible with bronchial atresia. After discharge, he remained well and voriconazole was discontinued 5 months after the initiation of therapy.

Conclusion: Bronchial atresia is a rare disease that is seldom complicated by a fungal infection, which is also a rare complication; however, physicians should consider fungal infections in patients with bronchial atresia who present with infections resistant to antimicrobial treatment.

Keywords: Aspergillus fumigatus; Congenital bronchial atresia; Fungal infection; Lung abscess.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

**Fig. 1**
Chest X-ray performed on admission showing an infiltrative shadow in the left lower lung field

**Fig. 2**
Contrast-enhanced CT performed on admission revealing an abscess, emphysematous changes, ectatic bronchi, a nodular lesion that was considered a mucoid impaction of the lingular segment (arrow), and disrupted bronchus within the left lower lobe (arrowhead) (a–c). A small mass lesion near the left second carina (arrow) is also shown (d)

**Fig. 3**
Histopathological assessment of the mass lesion near the left second carina obtained via endobronchial ultrasound-guided transbronchial needle aspiration revealed the presence of filamentous fungi (Grocott staining, × 40)

**Fig. 4**
The lingular and basal segments of the left lung were resected, and abscess was macroscopically confirmed

**Fig. 5**
Histopathological assessment of the resected lung showed emphysematous change and ectatic bronchus (arrows) of left basal segments (a,b) (Hematoxylin and Eosin staining, × 40)

See this image and copyright information in PMC

Cited by

A case of congenital bronchial atresia with tracheobronchial stenosis caused by emphysema: Successful management with thoracoscopic surgery.
Lin H, Tian S, Niu C, Shen X, Wang M, Wan C, Shi B, Chen H, He M, Bai C, Huang H.Lin H, et al.Heliyon. 2024 Jun 8;10(11):e32753. doi: 10.1016/j.heliyon.2024.e32753. eCollection 2024 Jun 15.Heliyon. 2024.PMID:38912456Free PMC article.
Congenital bronchial atresia presenting with chronic cough in a young male.
Kumar K, Sharma N, Marwah V, Vasan AS.Kumar K, et al.Lung India. 2023 Sep-Oct;40(5):475-477. doi: 10.4103/lungindia.lungindia_50_23.Lung India. 2023.PMID:37787367Free PMC article.No abstract available.

References

1. Ramsey BH, Byron FX. Mucocele, congenital bronchiectasis, and bronchogenic cyst. J Thorac Surg. 1953;26:21–30. doi: 10.1016/S0096-5588(20)30828-X. - DOI - PubMed
1. Wang Y, Dai W, Sun Y, Chu X, Yang B, Zhao M. Congenital bronchial atresia: diagnosis and treatment. Int J Med Sci. 2012;9:207–212. doi: 10.7150/ijms.3690. - DOI - PMC - PubMed
1. Lacquet LK, Fornhoff M, Dierickx R, Buyssens N. Bronchial atresia with corresponding segmental pulmonary emphysema. Thorax. 1971;26:68–73. doi: 10.1136/thx.26.1.68. - DOI - PMC - PubMed
1. Raynor AC, Capp MP, Sealy WC. Lobar emphysema of infancy: diagnosis, treatment, and etiological aspects-collective review. Ann Thorac Surg. 1967;4:374–385. doi: 10.1016/S0003-4975(10)66527-7. - DOI - PubMed
1. Yamamoto J, Shimanouchi M, Hashizume T, Suito T. Acquired bronchial atresia due to endobronchial tuberculosis. Kyobu Geka. 2015;68:836–839. - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Movatterモバイル変換

Account

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Full text links

Actions

Share

Congenital bronchial atresia complicated by a lung abscess due to Aspergillus fumigatus: a case report

Affiliations

Congenital bronchial atresia complicated by a lung abscess due to Aspergillus fumigatus: a case report

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Substances

Related information

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical