Cast bronchitis in a cystic fibrosis child: Experience with direct instillation of dornase alfa as an adjunct treatment agent

Abstract

Introduction: Lobar atelectasis is one of the common problems in patients with cystic fibrosis and can be a cause of respiratory symptoms in these patients even in the absence of bacterial infection. Case Presentation: Here we introduce a 9-year-old boy with cystic fibrosis who had many admissions because of respiratory distress due to lung collapse mainly caused by plastic bronchitis. Conclusions: In a number of patients with cystic fibrosis, lobar atelectasis is seen which is resistant to medical treatments. Early fiberoptic bronchoscopy as a measure for mechanical removal of the blocking agent and sometimes direct injection of drugs like dornase alfa into the bronchus is a successful modality in the treatment of lobar collapses in chronic pulmonary diseases.