Page 11 / April 07
The patient has a bronchopulmonary foregut malformation compatible with bronchoesophageal fistula (most likely congenital) that causes frequent coughing and aspiration of food particles into the superior segment of right lower lobe. Repetitive aspiration leads to bronchopneumonia, bronchiolitis and destroys lung tissue. It presents as intra-alveolar hemorrhage and bronchiectasis which can explain all her symptoms of hemoptysis, failure to thrive and digital clubbing. Regarding the histologic findings of Actinomycetes, this organism typically inhabits the oropharynx and can infect the lung via aspiration.
Next page /
ANSWER:
The patient has a bronchopulmonary foregut malformation compatible with bronchoesophageal fistula (most likely congenital) that causes frequent coughing and aspiration of food particles into the superior segment of right lower lobe. Repetitive aspiration leads to bronchopneumonia, bronchiolitis and destroys lung tissue. It presents as intra-alveolar hemorrhage and bronchiectasis which can explain all her symptoms of hemoptysis, failure to thrive and digital clubbing. Regarding the histologic findings of Actinomycetes, this organism typically inhabits the oropharynx and can infect the lung via aspiration.
How can we distinguish Congenital from Acquired Bronchoesophageal fistula?
Next page /