Tracheovascular Fistula in a 1.5-Year-Old Infant Presenting with Recurrent Lower Respiratory Infections

A 1.5-year-old patient with a history of recurrent pneumonia or tracheobronchitis episodes occurring almost monthly, associated with frequent vomiting and a chronic cough, was admitted to our ENT ward for further evaluation. At the time of admission, the patient was asymptomatic from a respiratory standpoint.

Routine laboratory investigations, including complete blood count and inflammatory markers, were within normal limits. A chest X-ray showed no pathological findings. Given the recurrent nature of the respiratory infections and the absence of abnormalities on imaging, a diagnostic rigid endoscopy was performed to assess the airway.

Endoscopic examination revealed a tracheo-vascular fistula located at approximately the mid-portion of the trachea. Following this finding, the patient was promptly transferred to the Pediatric Surgery Clinic, where surgical correction was performed. The postoperative course was uneventful, and the patient achieved full recovery.

This case highlights the importance of considering congenital or acquired tracheal anomalies in infants presenting with recurrent lower respiratory tract infections unresponsive to conventional therapy and normal imaging findings. Early endoscopic evaluation can be crucial for diagnosis and successful management.