Bronchotetany

BRONCHOTETANY, an acute disease of the respiratory tract, described in 1919 in children by Lederer, and consisting of tonic spasms of the smallest bronchi on the basis of spasmophilia; it may develop as one of the symptoms of manifest spasmophilia or be the first manifestation of its latent form. Clinically, the disease resembles severe pneumonia: flaring of the nostrils, severe expiratory dyspnea (with stridor), cyanosis, vicarious emphysema, in some places areas of muffled sound with rales. On autopsy, however, inflammatory changes are not found, but areas of atelectasis, edema, and vicarious distension of unaffected parts of the lung are found. Differentiation from pneumonia is very difficult, especially when dealing with a rachitic child with symptoms of spasmophilia; milder cases may very much resemble bronchial asthma. Data from radiography (absence of solid pneumonic shadows) and results of antispasmodic or antiasthmatic therapy help in making the diagnosis. B. is rare; cases described in the literature concern mainly severe forms of B. with fatal outcome; in milder cases recovery is also possible. Treatment of B. is the same as for an acute attack of tetany.