[Post-infectious autobullectomy].

Revue des maladies respiratoires

PubMedID: 25433592

Vella-Boucaud J, Chouabe S, Bourin F, Nardi J, Perotin JM, Lebargy F, Deslee G. [Post-infectious autobullectomy]. Rev Mal Respir. 2014;31(9):859-63.
Bullous emphysema is defined as an airspace of more than 10mm in diameter. The spontaneous regression or disappearance of a bulla is unusual, described as an "autobullectomy".

We report the case of a 37-year-old man with a 10-pack/year history of smoking, a history of pneumothorax surgically treated in 2005, and emphysema with a bulla in the right upper lobe. In September 2010, the patient was hospitalized for a community-acquired pneumonia associated with an air-fluid level in the bulla. Clinical symptoms improved with a course of antibiotics (levofloxacin, ceftriaxone) for 3 weeks. Chest X-rays showed a progressive decrease in the size of the bulla. In June 2011, a chest CT scan showed complete regression of the bulla in the right upper lobe.

We report the complete regression of a bulla after infection, leading to an "autobullectomy". It can be hypothesized that the mechanisms might involve fibrosis of the walls and/or the obstruction of the bronchus supplying the bulla.