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Etiology and Clinical Characteristics of Community-Acquired Pneumonia with Airway Malacia in Children
Wang Yu-Qing1, Hao Chuang-Li1, Ji Wei1
1Department of Respiratory Disease, Children's Hospital Soochow University, Suzhou 215003, China.
Objective:
The objective of this article is to study the etiology of community-acquired pneumonia in children with airway malacia.
Methods:
We retrospectively reviewed the medical records of 428 pneumonia patients. All patients underwent bronchoscopy, and bronchoalveolar lavage samples were processed for microbiological assessment.
Results:
In a total of 428 cases reviewed, 60 were found to have airway malacia. Pathogens were identified in 44 of the 60 specimens (73.3%), with 32 being single-pathogen infections. The most common pathogen was respiratory syncytial virus (RSV; 20%). Mixed-pathogen infections were observed in 12 patients. Airway malacia patients were younger than those without malacia (10.5 vs. 50 months, respectively; p < 0.001). Compared with those without airway malacia, wheezing, cyanosis and admission to the pediatric intensive care unit were more common in children with airway malacia and their hospital stay was longer.
Conclusion:
RSV was the most common pathogen in those with airway malacia. Airway malacia was found to aggravate infectious pneumonia.
Insights
Community-acquired pneumonia in children with airway malacia is often caused by respiratory syncytial virus (RSV). Airway malacia can worsen pneumonia severity and prolong hospital stays.
Area of Science:
- Pediatrics
- Infectious Diseases
- Respiratory Medicine
Background:
- Community-acquired pneumonia (CAP) is a significant cause of childhood illness.
- Airway malacia, a congenital condition, may predispose children to recurrent or severe respiratory infections.
- Understanding the specific etiological agents in children with airway malacia is crucial for targeted treatment.
Purpose of the Study:
- To investigate the causative pathogens of CAP in pediatric patients diagnosed with airway malacia.
- To compare clinical characteristics and outcomes of pneumonia in children with and without airway malacia.
Main Methods:
- Retrospective review of medical records for 428 pediatric pneumonia patients.
- Performance of bronchoscopy and microbiological assessment of bronchoalveolar lavage samples.
- Statistical analysis to compare patient groups with and without airway malacia.
Main Results:
- Sixty out of 428 patients had airway malacia.
- Respiratory syncytial virus (RSV) was the most common pathogen (20%) identified in patients with airway malacia.
- Children with airway malacia were younger, experienced more wheezing and cyanosis, required more pediatric intensive care unit admissions, and had longer hospital stays compared to those without malacia.
Conclusions:
- RSV is the predominant pathogen in pediatric CAP associated with airway malacia.
- Airway malacia appears to exacerbate the severity of infectious pneumonia in children.