Post-infectious bronchiolitis

Case contributed by Suraindra Mark Rajadurai
Diagnosis almost certain

Presentation

Chronic cough and multiple allergies.

Patient Data

Age: 40 years
Gender: Female

Chest

x-ray

There is increased lucency through the left hemithorax with evidence of bronchiectasis in the left lower lobe. The right lung is clear. 

Chest

ct

Hyperlucent left lung with decreased vascularity. Marked bronchiectasis in the left lower lobe and less prominent bronchiectasis in the left upper lobe. The right lung is essentially normal. Appearances are most in keeping with post-infectious bronchiolitis (Swyer-James syndrome).

Case Discussion

This case demonstrates the classic appearance of a hyperlucent hemithorax due to post-infectious obliterative bronchiolitis.

Post-infectious obliterative bronchiolitis most often occurs after a viral respiratory infection in early childhood. While the images were not available, reports from imaging 25 years prior to this CT confirmed the patient had similar appearances as a teenager. 

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