Analysis of Clinical Characteristics and Risk Factors of Plastic Bronchitis in Children With Mycoplasma pneumoniae Pneumonia.

Haiqin Zhong,Chao Sun,Kun Jiang,Rong Yin,Xiaoyan Dong,Ran Zhao

doi:10.3389/fped.2021.735093

Haiqin Zhong, Chao Sun + Show 4 more

Open Access

https://doi.org/10.3389/fped.2021.735093

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Abstract

Objective: To analyze the clinical characteristics of plastic bronchitis (PB) in children with Mycoplasma pneumoniae pneumonia (MPP) in order to explore its risk factors.Methods: A retrospective analysis was performed in MPP children receiving bronchoscopy admitted to department of respiratory medicine in Shanghai Children's Hospital from January 2018 to December 2020. According to the bronchoscopic findings, the patients were divided into PB group and non-PB group. The clinical manifestations, laboratory examination, etiology, treatment methods and outcomes of the children were analyzed. Logistic regression was used to analyze the risk factors for PB in children with MPP.Results: A total of 296 children with MPP were enrolled in the study, including 42 (14.2%) children in the PB group and 254 (85.8%) children in the non-PB group. There was no difference in the ratios of gender, age, proportion of fever, cough, wet rales, and wheezing rales between the two groups (P > 0.05). The univariate analysis showed that there were significant differences between the PB group and the non-PB group in LDH, D-dimer, CD3+CD4+(%), CD3+CD4+/CD3+CD8+, CD3 count, CD4 count, CD8 count, complement 3, IL8, IL-1β, IL-2, IL-10 (P < 0.05). The multivariate logistic regression analysis showed that fever duration > 12 d, IL-8 > 2,721.33 pg/ml, LDH > 482 U/L and complement 3 <1.02 g/L were independent risk factors for PB in children with MPP.Conclusions: Children with PB caused by MPP have protracted fever, a strong inflammatory response and immune function disturbance.

Highlights

Mycoplasma pneumoniae (MP) is a common pathogen of community-acquired pneumonia (CAP) in children
The inclusion criteria were as follows: x The condition met the diagnostic criteria for Mycoplasma pneumoniae pneumonia [8] i.e., CAP cases met one of the following criteria: (i) a single dose of serum Mycoplasma pneumoniae antibody MP-Ab ≥ 1:160; (ii) the titer of MP-Ab increased or decreased by 4 times or more in the recovery and acute stages; (iii) the copy number of MP-DNA in nasopharyngeal swabs, sputum, bronchoalveolar lavage fluid (BALF) and pleural effusion was >500/ml. y The condition met the diagnostic criteria of plastic bronchitis: taken out plastic foreign body by bronchoscopy. z Informed consent was signed for bronchoscopy examination. { Complete hospitalization data were available
The results showed there was no significant difference in the C-reactive protein (CRP) levels between the Plastic bronchitis (PB) and non-PB groups of children with Mycoplasma pneumoniae pneumonia (MPP)

Summary

Introduction

Mycoplasma pneumoniae (MP) is a common pathogen of community-acquired pneumonia (CAP) in children. Mycoplasma pneumoniae pneumonia (MPP) accounts for 10–40% of CAP in hospitalized children [1,2,3]. The disease onset and progression are rapid, with the manifestations of a high fever, cough, progressive dyspnea and difficulty improving hypoxemia, which can be quickly relieved after plastic is removed by bronchoscopy [5]. Risk Factors for Plastic Bronchitis caused by infection, common pathogens include bacteria (such as Streptococcus pneumoniae) and viruses (such as influenza virus and adenovirus) [6, 7].

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