Case Report: Tracheobronchopathia osteochondroplastica with Pseudomonas aeruginosa recovered from bronchoalveolar lavage fluid
Year: 2026
Type: article
Study design: Case Report
Abstract: Background Tracheobronchopathia osteochondroplastica (TO) is an uncommon benign disorder characterized by osseous and/or cartilaginous submucosal nodules involving predominantly the anterolateral tracheobronchial walls. This case illustrates multimodal diagnosis and cautious interpretation of concomitant lower-airway bacterial recovery. Case presentation A 63-year-old man presented with a 3-month history of cough and scant whitish mucoid sputum. Computed tomography (CT) demonstrated partially calcified anterolateral tracheobronchial nodules with relative posterior-wall sparing, a right-sided patchy pulmonary opacity, and multiple pulmonary nodules. Retrospective airway measurements showed a minimum tracheal luminal area of 179.4 mm 2 and a minimum diameter of 10.0 mm at the same level. Bronchoscopy revealed hard yellow-white nodules involving the trachea and proximal bronchi; biopsy showed mature lamellar bone, supporting TO. A pooled bilateral bronchoalveolar lavage specimen obtained after empirical piperacillin/tazobactam had been started yielded Pseudomonas aeruginosa at >10⁴ CFU/mL, susceptible to piperacillin/tazobactam and levofloxacin. The patient received 5 days of intravenous piperacillin/tazobactam followed by 9 days of oral levofloxacin and airway-clearance treatment, with symptomatic improvement. He completed the oral course without reported adverse effects. At an outpatient visit approximately 3 months after discharge, he was asymptomatic. The treating clinician's comparison of follow-up CT with baseline images showed resolution of the pulmonary opacity, unchanged airway nodules, and stable pulmonary nodules. Repeat cultures were not obtained. Conclusion Concordant CT, bronchoscopic, and supportive histopathologic findings establish the diagnostic pattern of TO. Clinical and radiologic improvement supported a concomitant respiratory infection, but the organism's causal role and any causal contribution of TO remained unproven. This distinction supports conservative airway management and continued surveillance without attributing every pulmonary abnormality to TO.
Source: Frontiers in Medicine
Institution: Hubei University of Medicine
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223155876