Supra-Cardiac Bronchogenic Cyst Masquerading as lower respiratory tract infection in a Young Infant: A Case Report

Abstract

Bronchogenic cysts are rare congenital malformations of the foregut that may present with nonspecific respiratory symptoms, often leading to misdiagnosis. We report a case of a 4-month-old boy with recurrent episodes of cough, fever, and respiratory distress, initially managed as bronchopneumonia during previous hospitalizations. Despite partial clinical improvement, the child developed oxygen dependency and intermittent stridor during weaning attempts. Radiological evaluation revealed left lung hyperinflation with a mediastinal shift, raising suspicion of an underlying mass. Point-of-care ultrasound identified a cystic lesion above the left atrium, which was further characterized by computed tomography (CT) as a well-defined mediastinal cyst compressing the tracheobronchial tree. The patient underwent successful surgical excision through thoracotomy. Histopathological examination confirmed the diagnosis of bronchogenic cyst. The postoperative recovery was uneventful. This case highlights the importance of maintaining a high index of suspicion for congenital cystic lesions in infants with recurrent or atypical respiratory symptoms. Early use of bedside ultrasound and advanced imaging can facilitate prompt diagnosis and management, preventing complications associated with airway compression.