Nebulized N-Acetylcysteine for Management of Plastic Bronchitis.

BACKGROUND: Plastic bronchitis is characterized by formation of extensive obstructive endobronchial casts and high recurrence rates. CASE CHARACTERISTICS: Two children (1-year-old girl, 7-year-old boy) who had recurrent episodes of respiratory distress with acute worsening. Bronchoscopy revealed membrane-like casts. Both children were managed with nebulized N-acetylcysteine in addition to management for asthma. OUTCOME: Symptom-free without recurrence for more than 9 months of follow-up. MESSAGE: Nebulized N- acetylcysteine may be helpful in prevention of recurrence of plastic bronchitis due to asthma.