Analysis of risk factors for plastic bronchitis induced by Streptococcus pneumoniae in children

Area of Science:

• Pediatric Pulmonology
• Infectious Diseases
• Critical Care Medicine

Background:

• Pneumococcal pneumonia is a common childhood infection.
• Plastic bronchitis (PB) is a rare but severe complication of pneumonia, characterized by the formation of bronchial casts.
• Identifying risk factors for PB is crucial for timely diagnosis and management.

Purpose of the Study:

• To investigate the clinical features of pneumococcal pneumonia.
• To identify independent risk factors for the development of plastic bronchitis in pediatric patients with pneumococcal pneumonia.

Main Methods:

• A retrospective study of 156 pediatric patients with pneumococcal pneumonia.
• Patients were categorized into groups based on the presence of plastic bronchitis and extrapulmonary complications.
• Statistical analyses included Mann-Whitney U test, chi-square test, multivariate analysis, and ROC curve analysis to identify risk factors.

Main Results:

• Pulmonary consolidation was more frequent in the right lower lobe.
• Patients with plastic bronchitis exhibited more severe mucosal erythema and abnormal secretion color compared to those without.
• Extrapulmonary complications were more prevalent in the plastic bronchitis group.
• Multivariate analysis identified mucosal erythema, secretion color, and procalcitonin (PCT) as independent risk factors for PB.
• ROC curve analysis indicated predictive value for mucosal erythema, secretion volume, secretion color, and PCT.

Conclusions:

• The amount of secretion, mucosal erythema, yellow-white secretion color, and PCT are significant independent risk factors for plastic bronchitis in pediatric pneumococcal pneumonia.
• These factors demonstrate high predictive value for identifying patients at risk of developing plastic bronchitis.