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Images in Thorax
Dry cough with abnormal airway connection
  1. Sumeet Vimal Kishor Singhania,
  2. Abhijit Raut
  1. Respiratory Medicine, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India
  1. Correspondence to Dr Sumeet Vimal Kishor Singhania, Respiratory Medicine, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, 400053, India; drsumeetsinghania{at}gmail.com

https://doi.org/10.1136/thorax-2023-220934

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    A 69-year-old man of Indian origin presented to the chest clinic with an excessive dry cough for 3 months. He did not report any weight loss, haemoptysis or fever. He had no history of recurrent cough, asthma, tuberculosis (TB) or close TB contact. He denied any nasal symptoms or significant reflux-related symptoms. He was known to have diabetes, hypertension and dyslipidaemia. Systemic examination was unremarkable. Chest X-ray was normal (figure 1A). A diagnosis of reactive airway disease was made, and inhaled corticosteroids were initiated. On follow-up after 3 weeks, his cough was no better. He denied having any fever and had a good appetite. A CT scan of the chest was requested.

    Figure 1

    (A)Normal chest X-ray. (B and C)CT images showing interbronchial fistula between right and left main bronchi. (D)Bronchoscopy image from carina showing fistula from the right main bronchus (arrow) and exudate in left main …

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    Footnotes

    • Contributors SVKS was the primary respiratory consultant looking after the patient. He performed the bronchoscopy and did the literature search for the article. AR is the consultant radiologist who reported the CT scan and provided images for the article and helped in the making of the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.