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Predictors for pediatric bronchitis obliterans in Mycoplasma pneumoniae pneumonia with bronchial casts

Jiaao Liu1, Le Wang1, Jianhua Liu1

  • 1Department of Respiratory, Hebei Clinical Reaserch Center for Children's Health and Diseases, Children' s Hospital of Hebei Province, No.133 Jianhua South Street, Shijiazhuang, 050031, Hebei Province, China.

Scientific Reports
|March 13, 2026
PubMed

Insights

Pediatric bronchitis obliterans (PBO) can develop from Mycoplasma pneumoniae pneumonia (MPP) with bronchial casts. High erythrocyte sedimentation rate (ESR), extensive pulmonary consolidation, and delayed bronchoscopy are key predictors of PBO in children with MPP.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Bronchitis obliterans (BO) is a serious complication of Mycoplasma pneumoniae pneumonia (MPP).
  • Identifying predictors for pediatric BO (PBO) in MPP patients with bronchial casts is crucial for timely intervention.
  • Previous studies have not focused on specific predictive factors for PBO in this context.

Purpose of the Study:

  • To identify significant predictors of pediatric bronchitis obliterans (PBO) in children hospitalized with Mycoplasma pneumoniae pneumonia (MPP) complicated by bronchial casts.
  • To evaluate the combined predictive value of identified factors for PBO.
  • To inform clinical practice regarding early detection and management of PBO.

Main Methods:

  • Retrospective analysis of 236 hospitalized children with MPP and bronchial casts.
  • Comparison of clinical, laboratory, radiological, and bronchoscopic features between PBO and non-PBO groups.
  • Multivariable logistic regression to identify independent predictors of PBO.

Main Results:

  • Children with PBO showed higher rates of pleural effusion, severe radiological abnormalities, and elevated inflammatory markers (CRP, WBC, ESR, IgM).
  • Delayed bronchoscopy (> 13.5 days) was more common in the PBO group.
  • Significant predictors for PBO included ESR > 57.5 mm/h, pulmonary consolidation > 2/3 of a lobe, and delayed bronchoscopy (P < 0.001).

Conclusions:

  • Erythrocyte sedimentation rate (ESR), extent of pulmonary consolidation, and timing of bronchoscopy are significant predictors of PBO in pediatric MPP patients with bronchial casts.
  • These factors can aid in the early identification of children at high risk for developing PBO.
  • Early detection and intervention strategies may improve outcomes for children with PBO.
Keywords:
Mycoplasma pneumoniae pneumoniaBronchial castBronchitis obliteransBronchoscopyChildrenPredictors

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