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Risk Factor Analysis of Mycoplasma pneumoniae Pneumonia Complicated With Plastic Bronchitis in Children: A

Jian-Min Dong1, Chun-Qing Zhou2, Yuan-Yuan Zhen3

  • 1Department of Pediatrics, Feicheng People's Hospital, Feicheng, China.

The Clinical Respiratory Journal
|December 4, 2025
PubMed
Abstract

Insights

This study identifies elevated erythrocyte sedimentation rate (ESR) and procalcitonin (PCT) as key risk factors for Mycoplasma pneumoniae pneumonia (MPP) complicated with plastic bronchitis (PB) in children. Early detection of these markers can aid in diagnosing this severe respiratory condition.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Respiratory Medicine

Background:

  • Mycoplasma pneumoniae pneumonia (MPP) can lead to severe complications.
  • Plastic bronchitis (PB) is a rare but serious condition characterized by the formation of bronchial casts.
  • Understanding the interplay between MPP and PB is crucial for effective management.

Purpose of the Study:

  • To investigate the clinical features and risk factors for pediatric Mycoplasma pneumoniae pneumonia (MPP) complicated with plastic bronchitis (PB).
  • To establish criteria for early diagnosis and treatment of MPP with PB.

Main Methods:

  • Retrospective analysis of clinical data from 75 pediatric patients with MPP who underwent bronchoscopy.
  • Stratification into PB and non-PB groups based on bronchial cast removal.
  • Comparative analysis of clinical characteristics and logistic regression to identify risk factors.
  • Proteomic analysis of bronchial casts using mass spectrometry.

Main Results:

  • Patients with PB showed significantly higher neutrophil ratios, ESR, C-reactive protein, lactate dehydrogenase, PCT, and D-dimer levels.
  • Elevated PCT (OR=1.071) and ESR (OR=1.088) were identified as independent risk factors for PB.
  • Bronchial casts in PB patients were found to be rich in fibrinogen.

Conclusions:

  • Children with MPP complicated by PB exhibit a more intense inflammatory response compared to those with MPP alone.
  • High ESR (>25.20 mm/h) and PCT (>0.19 μg/L) levels warrant vigilance for potential PB development.
  • The high fibrin content in bronchial casts suggests a link to abnormal coagulation and fibrinolysis activation due to inflammation.
Keywords:
Mycoplasmabronchitischild grouppneumoniaregression analysisrisk factors

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