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.