A female patient of 1 month and 20 days of age, born in due term with adequate weight, with no perinatologic history. She was admitted with low acute respiratory failure following pneumonia in the right superior lobe. Co-infection with RSV and Influenza A H1N1 virus was found. During her prolonged stay in PICU (111 days) she required MV due to ARDS with severe hypoxemia ( Figure 3 ). In five opportunities she passed an SBT but in all cases re-intubation was required within 48 hs owing to low respiratory involvement. Also, repeated presence of condensation in the right superior lobe was observed. Due to everything mentioned above, a respiratory endoscopy was performed, reporting a right anomalous tracheal bronchus and mild subglottic edema. Given the fact that the patient had several respiratory infections which led to an obstruction of the segment corresponding to the anomalous bronchus, an exeresis of the right anomalous tracheal bronchus and a segmentectomy of the right superior lobe were performed.