Rationale: According to current guidelines, rigid bronchoscopy is considered the gold standard for foreign body removal. However, we report the first case of successful removal of endobronchial necrotic material causing airway obstruction, which was associated with Haemophilus influenzae infection, using flexible bronchoscopy. Patient concerns: A young child presented with an airway obstruction secondary to H. influenzae infection, and culture of the viscous tracheal mass identified H. influenzae as the causative pathogen. Diagnoses: Bronchoscopic and pathological examinations further confirmed that the mass consisted of necrotic airway tissue. Interventions: Flexible bronchoscopy with irrigation and suction was performed to remove the foreign body located at the carina, effectively relieving the obstruction. Outcomes: This case demonstrates that H. influenzae infection can cause tracheal necrosis and the formation of viscous, mass-like foreign bodies that may lead to life-threatening airway obstruction, while flexible bronchoscopy proves to be an effective and minimally invasive method for their removal. Lessons: Clinicians should therefore be aware of the potential risk of airway obstruction due to viscous secretions associated with H. influenzae infection, as flexible bronchoscopy offers significant advantages in both the management and removal of such material.
Wu et al. (Fri,) studied this question.