Abstract
BackgroundAirway malacia is an important cause of noisy breathing, recurrent wheezing and respiratory infections, chronic coughing, and episodes of respiratory distress in young children. As the clinical manifestations of airway malacia are not common, many clinicians have insufficient understanding of this disease. So the purpose of this study is to summarize the pathogenic bacteria and clinical manifestations of airway softening complicated with pneumonia in children.MethodsChildren hospitalized with airway malacia complicated by pneumonia were eligible for enrollment from January 1, 2013 to December 31, 2019. Medical records of patients were reviewed for etiology, clinical characteristics, and laboratory examination results.ResultsA total of 164 pneumonia patients with airway malacia were admitted. The male-to-female ratio was 3:1. The age of patients ranged from 1 month to 4 years old. The median age was 6 (3–10) months. The most commonly detected pathogen were Mycoplasma pneumoniae (25/164, 15.24%), Streptococcus pneumoniae (18/164, 10.98%), and respiratory syncytial virus (16/164, 9.76%). Common signs among the 164 patients with confirmed airway malacia included cough (98.78%), wheezing (67.07%), fever (35.37%), intercostal retractions (23.17%), dyspnea (10.98%), cyanosis (11.11%), and crackles (50%). Compared with those without airway malacia, the incidence of premature delivery and mechanical ventilation was higher, and the duration of symptoms before admission (median, 13.5 d) and hospital stay (median 10.0 d) were longer. Of the children with pneumonia, 11.59% of those with airway malacia required supplemental oxygen compared with 4.88% of those without airway malacia (p < 0.05).ConclusionThe median age of children with airway malacia was 6 months. The most common pathogen in patients with airway malacia complicated by pneumonia was Mycoplasma pneumoniae. Patients with airway malacia complicated by pneumonia often presented with a longer disease course, more severe symptoms, and had delayed recovery.
Highlights
Airway malacia is an important cause of noisy breathing, recurrent wheezing and respiratory infections, chronic coughing, and episodes of respiratory distress in young children
Demographic characteristics A total of 164 patients with airway malacia complicated by pneumonia were recruited to the study (Table 1)
This study found that about 20% of children with long-term cough, wheezing, and recurrent infections who underwent bronchoscopy had airway malacia between January 2013 and November 2019, which is consistent with domestic research but higher than that reported in foreign research
Summary
Airway malacia is an important cause of noisy breathing, recurrent wheezing and respiratory infections, chronic coughing, and episodes of respiratory distress in young children. As the clinical manifestations of airway malacia are not common, many clinicians have insufficient understanding of this disease. Airway malacia is a disease referring to an excessive collapse of the airway, which is caused by disproportionate laxity of the posterior wall (pars membranacea) or compromised cartilage integrity [1]. This concept was first proposed by Baxter and Dunbar in 1963. Airway malacia could occur in isolation, or in association with other congenital or acquired conditions [2] This study aimed to summarize the pathogens and clinical presentation of pneumonia in children with airway malacia, and to compare these with those in children without airway malacia to provide a scientific basis for making early diagnoses and identifying reasonable treatments
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