A 44-year-old man with a history of two episodes of pneumonia in high school presented with a three-day history of a productive cough and fever. Chest computed tomography showed a posterior mediastinal low-density area, suggesting a diagnosis of mediastinitis, with multiple cystic lesions around the trachea and main bronchi (Picture 1). Bronchoscopy revealed multiple pouches on the right side of the membranous trachea, carina (Picture 2), and main bronchi; however, we were unable to determine which pouch was responsible for the infection. Streptococcus pneumoniae was detected with a sputum culture. Treatment with antibiotics gradually improved his symptoms. Multiple tracheobronchial diverticula are rare and often asymptomatic. However, some patients may present with chronic cough, dyspnea, hemoptysis, and recurrent airway infections (1). When diverticula become infected, serious complications [e.g., mediastinitis (2) and empyema] may arise. This case highlights the importance of close monitoring in patients with tracheobronchial diverticula who experience respiratory symptoms and a fever.
Picture 1.
Picture 2.
The authors state that they have no Conflict of Interest (COI).
References
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