CRA7 TAMING TENACIOUS MUCUS: TYLOXAPOL AS AN ADJUNCT THERAPY FOR ATELECTASIS

Zulkifli.S1
Hospital Pakar Sultanah Fatimah, Muar

Introduction
Mucus obstruction in the airways can lead to devastating lung collapse, posing significant challenges. The non-ionic surfactant Tacholiquin has demonstrated efficacy in resolving acute lung collapse due to obstructive mucus plugs when conventional therapies fail, highlighting its valuable properties.

Case Report
A 37-year-old Malay gentleman presented to us with complaints of chronic cough, hemoptysis and weight loss of 10kg since November 2023. He underwent CECT Thorax and Abdomen which showed right hilar mass, bilateral supraclavicular, axillary lymphadenopathy with lung, adrenal and bone metastasis. He was then subjected to LN supraclavicular biopsy on 15/11/23 which showed metastatic undifferentiated carcinoma which was positive for pancytokeratin, CK7 with negative EGFR, ROS and ALK rearrangement. At this point he was referred to the Oncology team in Muar and planned to start chemotherapy after tracing his lung cancer panel analysis.

He then presented in End January 2024 with a sudden complaint of shortness of breath, cough and right sided chest pain. Chest Xray shows acute total collapse of right lung which was not present during the previous admission. He requires high flow oxygen and repeated CT shows worsening right hilar mass with mass effect. Steroids and conventional mucolytic therapy was started for him with inpatient chest physiotherapy for 4 days. Repeated CXR still showing collapsed right lung.

He was given nebulization Tacholiquin 1% 5mls twice daily for 5 days on top of continuing the conventional treatment. His condition subsequently improved and able to wean oxygen slowly and repeated Xray on 7/2/2024 shows a totally expanded right lung. He was subjected for his first Pemetrexed chemotherapy.

Conclusion
Tacholiquin effectively resolved acute lung collapse due to an obstructive mucus plug when conventional treatments failed, highlighting its ability to liquefy thick secretions and facilitate airway clearance in managing atelectasis caused by mucus obstruction.