There is no confirmatory diagnostic test for pulmonary hydatid cyst other than surgical excision and histopathologic confirmation. Imaging is at best suggestive and serology does not have a satisfactory sensitivity. We present a series of children wherein flexible fibreoptic bronchoscopy under conscious-sedation, revealed hydatid membranes in airways. Broncho-alveolar lavage analysis confirmed hydatid in half of them. We propose flexible fibreoptic bronchoscopy with broncho-alveolar lavage as a confirmatory diagnostic test for pulmonary hydatid in children. To the best of our knowledge, this is a completely novel approach to the condition with potential to alter the diagnostic paradigm.

A 12-year-old girl presented with chronic suppurative lung disease secondary to an old forgotten, foreign body (plastic whistle) in the right lower lobe bronchus, confirmed by Contrast enhanced computer tomography (CECT) chest. Rigid bronchoscopic removal was attempted twice but the foreign body could not be removed. Under general anesthesia, a flexible bronchoscope was inserted through the rigid bronchoscope and the foreign body was grasped and removed using rat-toothed forceps inserted through the suction channel of the flexible scope. Although there are a few reports of sequential use of flexible and rigid bronchoscopies, this report highlights the feasibility and utility of flexible through rigid bronchoscopy technique for foreign body removal in the distal airways.

Antiglomerular basement membrane disease is a small vessel vasculitis which affects the lungs and kidneys, causing diffuse alveolar haemorrhage and rapidly progressive glomerulonephritis respectively. It is extremely uncommon in children. Diagnosis requires the presence of specific anti-GBM autoantibodies. Presentation with renal involvement is much more common than pulmonary involvement. However, a small proportion of cases might have isolated pulmonary involvement. Minimal changes on renal biopsy could still be present in these patients. Treatment of antiglomerular basement membrane disease includes plasmapheresis and immunosuppression. We present a case where a 7 year old boy presented with a long history suggestive of pulmonary haemorrhage but no renal manifestations and was diagnosed on the basis of anti-GBM autoantibodies and renal biopsy. He responded well to immunosuppressive therapy alone.