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Characteristics of plastic bronchitis in children with infectious pneumonia
Xulong Cai1,2, Mali Lin3, Li Zhou4,5
1Department of Pediatrics, Affiliated Hospital 6 of Nantong University, 2 Xindu West Road, Yancheng, 24000, China. caixulong2017@163.com.
Insights
Plastic bronchitis (PB) in children with pneumonia presents with longer illness duration and distinct clinical signs. Mycoplasma pneumoniae is a common pathogen, and PB may contribute to pulmonary necrosis.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Critical Care Medicine
Background:
- Infectious pneumonia can lead to plastic cast production, posing a health risk to children.
- Plastic bronchitis (PB) is a serious complication of pneumonia requiring further clinical characterization.
Purpose of the Study:
- To explore the clinical characteristics of plastic bronchitis (PB) in children with pneumonia.
- To identify differences between patients with and without PB and analyze pathogen distribution.
Main Methods:
- Retrospective analysis of clinical medical records of children with pneumonia and large chest shadows.
- Comparison of clinical characteristics, laboratory findings, and pathogen distribution between PB and non-PB groups.
- Grouping analysis based on PB and pathogen conditions.
Main Results:
- 185 patients were analyzed; 48 had PB. PB patients had longer pre-hospitalization illness duration and more frequent inspiratory three concave signs.
- Elevated D-D dimer, LDH, ALT, and AST were significantly higher in the PB group. Mycoplasma pneumoniae (MP) was the predominant pathogen in both groups.
- Pleural effusion onset timing differed between MP-positive and MP-negative PB cases. Pulmonary necrosis distribution varied between PB and non-PB groups.
Conclusions:
- Mycoplasma pneumoniae is a common pathogen in PB, whether as a single or multiple pathogen infection.
- Plastic bronchitis may be a potential cause of pulmonary necrosis.
- Clinical manifestations of PB are diverse, influenced by host and pathogen factors.
Background:
Multiple studies have reported that infectious pneumonia can induce the production of plastic casts, which threatens children's health. We explored the characteristics of plastic bronchitis (PB) in clinical practice by analysing clinical medical records.
Methods:
A retrospective study was conducted. Children with pneumonia and large chest shadows were included in this study. The differences in characteristics between patients with plastic bronchitis and those without plastic bronchitis were analysed. The distribution of pathogens was statistically analysed. Grouping analysis based on PB and pathogen conditions was also conducted.
Results:
A total of 185 patients were included in this study. The patients were divided into two groups: the PB group (n = 48) and the non-PB group (n = 137). The duration of illness before hospitalization in the PB group was mostly longer than that in the non-PB group. The frequency distribution of the inspiratory three concave signs in the PB group was significantly greater than that in the non-PB group. Compared with those in the non-PB group, the number of patients with abnormally elevated of D-D dimer, LDH, ALT, and AST in the PB group was significantly greater. Mycoplasma pneumoniae (MP) was the main pathogen observed in both the PB and non-PB groups. In cases of MP infection without plastic bronchitis, treatment with macrolide antibiotics occurred significantly earlier. Most cases of pleural effusion in the PB-MP group were discovered more than 7 days after onset. However, in the PB-nonMP group, most cases of pleural effusion were detected within 7 days of onset. There was a difference observed in the distribution of pulmonary necrosis between the PB group and the non-PB group.
Conclusions:
MP is a common pathogen observed in PB cases caused by single-pathogen infections and multiple-pathogen infections. PB may be a potential cause of pulmonary necrosis. Furthermore, PB exhibits diverse clinical manifestations due to host and pathogen factors.
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