Clinical characteristics of infection-related plastic bronchitis in children

GUO Yong-sheng; ZOU Ying-xue; WANG Yi-fan

doi:10.19538/j.ek2025060613

Abstract：Objective To analyze the clinical features of infection-associated PB(Plastic Bronchitis)in children,to explore the characteristics of age and season of occurrence,and infectious agents of PB in children,and to provide a basis for the early recognition of PB and the development of feasible treatments.Methods The clinical data of 1062 cases with clinical diagnosis of PB admitted to Tianjin Children's Hospital from January 2017 to December 2023 were retrospectively analyzed to analyze the patterns of season,age,and etiology of onset,as well as the combined intrapulmonary and extrapulmonary complications of PB and the overall prognostic characteristics.Results A total of 1062 children with infection-related PB were enrolled in this study.The seasonal distribution was:spring(149 cases,14.0％),summer(186 cases,17.5％),fall(367 cases,34.6％),and winter(360 cases,33.9％),with higher incidence in fall and winter.The age distribution was:0-1 year old(244 cases,23.0％),＞1-3 years old(142 cases,13.4％),＞3-6 years old(229 cases,21.6％),＞6-12 years old(410 cases,39.4％),＞12-18 years old(28 cases,2.7％),and the prevalent age was 6-12 years old(39.4％).The etiologic distribution was as follows:no definite pathogen detected(443 cases,41.7％),viral infection(29 cases,2.7％),Mycoplasma pneumoniae infection(503 cases,47.4％),bacterial infection(9 cases,0.8％),and mixed infections(78 cases,7.3％),with Mycoplasma pneumoniae being the most common pathogen.The incidence of intrapulmonary complications was pleurisy(245 cases,23.1％),pulmonary atelectasis(246 cases,23.2％),and pleural effusion(258 cases,24.3％).The incidence of extrapulmonary complications was as follows:neurological system(20 cases,1.9％),circulatory system(20 cases,1.9％),hematologic system(17 cases,1.6％),digestive system(88 cases,8.3％),urological system(89 cases,8.4％),and skin and mucous membrane injuries(31 cases,2.9％),with a predominance of the digestive system and the urinary system.The median length of hospital stay for all patients was 7.0(5.0,10.0)days.Follow-up was conducted for 3 months to 1 year after discharge.The resolution of chest imaging findings was observed in 340 cases(32.0％)at 2 weeks after discharge,702 cases(66.1％)at 4 weeks,954 cases(89.8％)at 8 weeks,and 1,039 cases(97.8％)at 6 months.An additional 23 cases(2.2％)achieved near-complete resolution between 6 months and 1 year after discharge,or were with residual linear opacities or fibrotic-like changes at previously affected sites.Conclusion PB occurs more often in fall and winter,mostly in children＞6-12 years old,the most common pathogen is Mycoplasma pneumoniae,and the overall prognosis is good.