Tracheal Bronchus: A Rare Etiology of Recurrent Pneumonia in Children

Recurrent infections are a common cause for seeking medical care and they result in significant parental anxiety and concerns. Although immunodeficiency disorders are an important underlying cause of recurrent infections, the majority of children with recurrent infections do not have any dysfunction in their immune systems. We present the case of an 11-year-old boy who was brought to the outpatient department by his parents because of a complaint of productive cough for the last one week that was associated with low-grade fever. The patient had a history of frequent episodes of pneumonia. He developed three episodes of pneumonia within the last year. According to the parents, the patient was investigated previously for possible immunodeficiency disorders, but the findings did not reveal any abnormal results. His siblings are healthy and have no history of recurrent infections or immunodeficiency disorders. The vital signs were within the normal limits. The patient was treated empirically with the antibiotic course of amoxicillin. The patient was given a follow-up appointment one week later. In the follow-up visit, the patient had complete resolution of the infection. The parents expressed concern about their child having recurrent episodes of infections. The patient underwent a high-resolution CT scan of the thorax to rule out any structural abnormalities. The scan demonstrated the presence of an aberrant bronchus arising from the lateral wall of the trachea above the level of the carina and supplying the apical segment of the right upper lobe. This finding is often referred to as a "tracheal bronchus." The tracheal bronchus is a rare congenital anomaly of the respiratory tract. It should be considered in the differential diagnosis of children with recurrent pneumonia with no infections in other organ systems to suggest immunodeficiency disorder.