PMC4722097_01
Thoracic computed tomography (CT) of the right upper lobe. The initial CT showed no abnormality. Four days after admission, CT showed increased thickness of the bronchial wall. In a short period, the bronchiole was obstructed and enlarged. Extended parenchymatous opacity was observed along the obstructed bronchi 7 days after admission. Twenty-one days after admission, progression of consolidation including cystic bronchiectatic lesions. Sixty-three days after admission, CT showed remarkable improvement of the infiltrative shadows. One hundred thirty-three days after admission, most infiltrative shadows had disappeared.
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A chest radiograph showed no abnormalities, but thoracic computed tomography (CT) showed thickening of bronchial walls, suggesting bronchitis (Fig. 1). Distal portion of the obstructed bronchi showed cystic bronchiectatic lesions in the right upper lobe (Fig. 1).
Bronchoscopic examination revealed extensive tissue necrosis and pseudomembrane formation in the right upper lobe bronchus. These bronchi were occluded by the membrane.
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The patient underwent flexible bronchoscopy 27 days after admission, which revealed multiple, discrete whitish plaques involving the trachea and the right upper lobe bronchus (Fig. 2).