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What is Plastic Bronchitis?

Mary McMahon
Updated Mar 03, 2024
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Plastic bronchitis is an unusual respiratory condition where materials build up in the airways, forming a cast and impeding the patient's ability to breathe. These casts have a rubbery texture and contain varying levels of fibrin and mucin, depending on the circumstances leading to their formation. Sometimes, patients manage to expectorate the casts, and in other cases, they need to be removed during surgery or bronchoscopy to clear the patient's airways. Plastic bronchitis is primarily seen among children and teens.

This condition appears to be linked with some congenital heart conditions and it can also develop in other circumstances. The patient often experiences several days of discomfort with coughing and the production of pale sputum and may have difficulty breathing. Strange breath sounds, crackling noises in the lungs, and a feeling of tension and tightness in the chest can also be experienced in a patient with plastic bronchitis. Patients may also develop problems associated with not getting enough oxygen, such as cyanosis, where the extremities start to turn bluish-gray.

Patients who manage to cough up the casts will produce a remarkably detailed model of their bronchial tubes and should experience relief after the cast has been cleared. In cases where patients cannot expectorate the cast, medical imaging will usually reveal obstructions in the airways and the patient can be treated to remove them. Additional treatment when the airways are clear can include medications to treat inflammation and infection, along with treatments to limit mucus production to prevent the formation of new casts.

People at risk for plastic bronchitis may be warned ahead of time so they know to watch out for symptoms. Heart conditions are often associated with respiratory problems, and being aware of the increased risk of respiratory conditions can help patients take steps to avoid them or treat them early when they do appear. This can include exercising common sense to prevent infections, as well as using prophylactic antibiotics when recommended.

The relative rarity of this condition can make it challenging to diagnose, especially in an area where doctors are not likely to see very many cases. Patients in respiratory distress may not be identified as potential cases of plastic bronchitis until imaging of the lungs can be conducted to identify the obstructions in the airway, and treatment can be slowed by uncertainty about how to proceed. Most medical facilities have the personnel and equipment needed to perform a bronchoscopy and remove the casts before they occlude the airways any further.

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Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By anon998528 — On Jun 27, 2017

I am so glad to see this site that verifies this condition isn't all in my head. I have Churg Strauss Syndrome and for years I have been telling my doctors that I cough up mucus that looks like "melted plastic" whenever I was on an inhaled steroid. Being a nurse and curious I spread out some of the expectorated mucus and it was in the shape of bronchial tubes. The largest was just like some of the pictures I have found online. This spring I thought I wasn't going to make it as I was so short of breath.

With repeated Albuterol nebulizer treatments, violent coughing episodes and 24 hours later I had them all up. What followed was copious amounts of frothy sputum that got thinner and then stopped and I felt like a new person. I was told it was from the "eosinophils " but it only happens when I was on inhalers with a steroid. Haven't taken any since this last episode. Too bad I didn't preserve my specimen.

By bear78 — On Dec 23, 2012

When we say casts, people think of hard solid materials in the lungs. But that's not the case. Plastic bronchitis leads to a formation of a gelatin like substance in the airways. So when it is removed, it looks like something between fat and gelatin. It has the shapes of branches because that's what the airways look like.

By SarahGen — On Dec 23, 2012

@fify-- There are medications for bronchitis like antibiotics and different expectorants. But this type of bronchitis is not common and it's very difficult for people to cough this stuff on their own. It's terribly demanding on the lungs and plastic bronchitis already limits the capacity of the lungs. That's why surgery is usually required.

It's easier to prevent this condition than to treat it. Patients can use natural expectorants to keep their lungs clean to prevent the casts from forming.

By fify — On Dec 22, 2012

Oh wow, what a terrible condition. I can't imagine someone coughing up solid materials from their lungs like that. That must be so painful.

Aren't there any medications to help break up these materials in the lung so that they can be expectorated more easily?

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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