Fatal bronchial asthma with bilateral lung collapse

Fatal bronchial asthma is classically characterized in pathology textbooks and journal articles as associated with lung hyperinflation at autopsy. The following is a report of a case of fatal bronchial asthma associated instead with bilateral lung collapse. This manifestation of asthma at autopsy has not been previously reported, to my knowledge. A 31-year-old man with a history of recurrent asthma was found in an unresponsive state in his automobile after a low-speed collision. Medical personnel during the resuscitation noted a decrease in breath sounds bilaterally and some wheezing. There was no escaping air with needle thoracostomies at the outset. Cardiac monitoring demonstrated pulseless electrical activity during most of the 30-minute resuscitation attempt. An autopsy disclosed collapsed lungs bilaterally. Microscopic examination of the lungs disclosed the characteristic histopathologic features of bronchial asthma.