Clinical History.—This 13-month-old baby boy was admitted to Children's Hospital of Pittsburgh because of wheezing of two days' duration. A chest roentgenogram was obtained (Fig 1). He had had meningitis at 3 months of age and recurrent otitis media and recurrent episodes of respiratory tract infection. He had been admitted to another hospital one month previously with a temperature of 42 °C and right upper-lobe pneumonia. The infant received antibiotics, his condition improved, and he was discharged home although he continued to have midanterior chest wall retractions.
On physical examination, his respirations were 40/min; pulse rate, 160 beats per minute; and temperature, 38.2 °C. He was in moderate respiratory distress, and midanterior chest wall retraction was noted. On auscultation, he had prolonged expiration with diffuse wheezing and bilateral rhonchi. Right bronchoscopy yielded purulent material and was followed by a right bronchogram (Fig 2).
Denouement and Discussion
Anomalous Apical Bronchus of the Right Upper Lobe
Anomalous bronchi of the right upper lobe