Isolated tracheal papillomatosis—An infrequent cause of chronic cough

We present the case of a 15 yr-old male who was referred to the respiratory department for investigation of a chronic cough that was severely affecting his daily activities. He had previously been diagnosed with “psychogenic cough” in another institution. A bronchoscopy was performed which revealed mucosal abnormality on the posterior wall of the trachea. Biopsies of these lesions were suggestive of a viral aetiology and subsequent PCR analysis of the tracheal biopsy detected human papilloma virus (HPV) DNA subtypes 11 and 16.

HPV isolated to the trachea without evidence of more proximal involvement is rare. In our discussion, we present the aetiology, risk factors, treatment and complications of this condition. This case highlights the importance of a complete assessment of cough in all cases as recently described in the American College of Chest Physicians’ guidelines on the diagnosis and management of cough.