QUICKLY RESOLVING BRONCHIECTASIS AFTER INHALATIONAL INJURY

TOPIC: Pediatrics TYPE: Fellow Case Reports INTRODUCTION: Bronchiectasis is often considered to involve irreversible airway damage. We present a patient who developed significant bronchiectasis after smoke inhalation, with near complete resolution few months later. CASE PRESENTATION: An eight-year-old female presented she sustained injuries in trailer fire. She was intubated due facial burns, and had 35% total body surface area burns also including the distal extremities back. The day admission brief asystolic cardiac arrest. Bronchoscopy on hospital three revealed mild erythema consistent grade one inhalational injury. In weeks her injury two discrete episodes of acute respiratory distress syndrome requiring prone positioning, neuromuscular blockade, inhaled pulmonary vasodilators. CT scan chest ten days fire showed diffuse bilateral bronchiectasis, developing varicoid cystic left lower lobe. Subsequent bronchoscopies identified obstructing casts mucous plugs, an aggressive clearance regimen mucolytic therapies started. additionally treated antibiotics, corticosteroids, azithromycin. Tracheostomy considered, but ultimately able wean off ventilatory support. During subsequent while convalesced then progressed inpatient rehabilitation, did well from standpoint weaned. Repeat bronchiectasis. clinic four fire, reported returning school other activities no limitations standpoint. dyspnea endorsed only rare cough or sputum production. Pulmonary function tests (including spirometry, flow-volume loop, lung volumes, diffusing capacity) were normal exception low residual volume that attributed obesity. DISCUSSION: Most children fires do not have long-term morbidity1. However, inhalation known cause which typically progressive may result failure2. Our failure shortly injury, quickly improved just While classically thought as irreversible, there been reports improvement even particularly children3. CONCLUSIONS: without ongoing reasons for inflammation, severe be permanent. REFERENCE #1: Rosenberg M, Ramirez Epperson K et al. Comparison quality life pediatric burn survivors Burns. 2015; 41(4):721-726. #2: Hayes D. Lung transplantation inhalation. Burns 2011; 37(4): 24-28. #3: Gaillard EA, Carty H, Heaf D, Reversible bronchial dilatation children: comparison serial high-resolution computer tomography scans lungs. Eur J Radiol. 2003; 47(3):215-220. DISCLOSURES: No relevant relationships by Sarah Cohen, source=Web Response Katelyn Krivchenia,