Plastic bronchitis and a novel management approach with streptokinase inhalation therapy: a case study

Abstract

Plastic bronchitis (PB) is a rare condition of obstructive bronchial casts. The most common demographic that is affected by PB is children but adults with acute onset have also been reported. At present, there are no established guidelines for the management of PB which has led to the proposition of a variety of treatment regimens. Inhaled streptokinase (SK) can be one such treatment modality for this rare condition. An adult female patient presented to the Grodno university clinic with complaints of dyspnea, shortness of breath, and expectoration of firm, long, and branching bronchial casts. We used inhaled SK to treat this patient based on the cast composition on microscopic evaluation. Written consent was taken from the patient mentioned in the study. The study was approved by the hospital and institutional ethics committee. SK, a potent fibrinolytic agent, can be useful in lysing fibrin-rich bronchial casts. With Inhaled SK therapy, there was a gradual improvement in the overall condition of the patient. In the subsequent clinical follow-up, the patient was asymptomatic and without recurrent casts.  The course of treatment and positive recovery of the patient signifies the fact that inhaled SK can be a suitable therapeutic approach in PB. Therefore, based on our novel therapeutic approach, SK inhalation may be a possible treatment for bronchial casts in PB.