Persistent Hypoxemia After Bi-Basal Pneumonia in a 77-Year-Old Man: An Unusual First Presentation of Tracheobronchopathia Osteochondroplastica

Tracheobronchopathia osteochondroplastica is a rare but benign disease affecting the tracheobronchial tree. The main symptoms are productive cough, wheezing/stridor-dyspnea, and hemoptysis. We report the case of a 77-year-old man, who was admitted to our intensive care unit (ICU) for hypoxemia secondary to bi-basal-pneumonia, treated by high-flow nasal cannula alternated with non-invasive ventilation. Swabs, urine antigens, and sputum cultures were negative for viruses, bacteria, mycobacteria, and fungus. Despite antibiotics for 7 days, severe hypoxemia persisted, so a bronchoscopy was performed leading to the unexpected diagnosis of tracheobronchopathia osteochondroplastica. The evolution was favorable under respiratory physiotherapy, bronchial aspirations by fiberoptic bronchoscopy, and non-invasive ventilation. The patient was discharged from ICU after 13 days and from hospital 6 days later, thereafter the course was uneventful.