Infected tracheal diverticulum: a rare association with alpha-1 antitrypsin deficiency

Tracheal diverticulum, defined as a benign outpouching of the tracheal wall, is rarely diagnosed in clinical practice. It can be congenital or acquired in origin, and most cases are asymptomatic, typically being diagnosed postmortem. We report a case of a 69-year-old woman who was hospitalized after...

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Bibliographic Details
Published in:Jornal brasileiro de pneumologia 2014-12, Vol.40 (6), p.669-672
Main Authors: Amaral, Cecília Beatriz Alves, Silva, Sónia, Feijó, Salvato
Format: Article
Language:English
Subjects:
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alpha 1-Antitrypsin Deficiency - complications
alpha 1-Antitrypsin Deficiency - drug therapy
Anti-Bacterial Agents - therapeutic use
Case Report
Deficiência de alfa 1-antitripsina
Diverticulum - complications
Diverticulum - drug therapy
Divertículo
Doenças da traqueia
Enfisema pulmonar
Female
Humans
Magnetic Resonance Imaging
Meropenem
Pulmonary Emphysema
RESPIRATORY SYSTEM
Thienamycins - therapeutic use
Tomography, X-Ray Computed
Tracheal Diseases - complications
Tracheal Diseases - drug therapy
Vancomycin - therapeutic use
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Summary:Tracheal diverticulum, defined as a benign outpouching of the tracheal wall, is rarely diagnosed in clinical practice. It can be congenital or acquired in origin, and most cases are asymptomatic, typically being diagnosed postmortem. We report a case of a 69-year-old woman who was hospitalized after presenting with fever, fatigue, pleuritic chest pain, and a right neck mass complicated by dysphagia. Her medical history was significant: pulmonary emphysema (alpha-1 antitrypsin deficiency); bronchiectasis; and thyroidectomy. On physical examination, she presented diminished breath sounds and muffled heart sounds, with a systolic murmur. Laboratory tests revealed elevated inflammatory markers, a CT scan showed an air-filled, multilocular mass in the right tracheal wall, and magnetic resonance imaging confirmed the CT findings. Fiberoptic bronchoscopy failed to reveal any abnormalities. Nevertheless, the patient was diagnosed with tracheal diverticulum. The treatment approach was conservative, consisting mainly of antibiotics. After showing clinical improvement, the patient was discharged.
ISSN:1806-3713
1806-3756
1806-3756
1806-3713
DOI:10.1590/S1806-37132014000600011