Clinical analysis of 8 children with plastic bronchitis associated with influenza A virus (H1N1) infection.
- Author:
Yue-jie ZHENG
1
;
Ji-kui DENG
;
Zhi-wei LU
;
Hong-ling MA
;
Jing LI
;
Li WANG
Author Information
- Publication Type:Journal Article
- MeSH: Antiviral Agents; administration & dosage; therapeutic use; Bronchitis; complications; diagnosis; therapy; virology; Bronchoscopy; Child; Child, Preschool; Foreign Bodies; complications; Glucocorticoids; administration & dosage; therapeutic use; Humans; Influenza A Virus, H1N1 Subtype; Influenza, Human; complications; virology; Intensive Care Units; Male; Pulmonary Atelectasis; diagnosis; therapy; virology; Rare Diseases; Respiratory Insufficiency; diagnosis; therapy; virology; Retrospective Studies; Tomography, X-Ray Computed; Treatment Outcome
- From: Chinese Journal of Pediatrics 2012;50(7):521-524
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo analyze the clinical characteristics of plastic bronchitis associated with 2009 influenza A virus (H1N1) infection.
METHODA retrospective investigation of the clinical manifestation, bronchoscopy, and the histology of the cast, clinical course and outcome of 8 children with plastic bronchitis associated with influenza A virus (H1N1) infection during winter of 2009 and 2010 was performed.
RESULTAll 8 cases were boys, the range of age was 3 to 6 years. Five cases occurred in 2009 winter, accounting for 3.3% (5/150) of hospitalized children with influenza A (H1N1) infection; 3 cases occurred in 2010 winter, accounting for 15.8% (3/19) of hospitalized children with influenza A (H1N1) infection. Two patients had an underlying chronic disease, 1 had asthma, and the other had allergic rhinitis and atopic dermatitis. All the 8 cases had fever, cough and sputum; 2 had wheezing; 5 had respiratory distress. All 8 cases were diagnosed as influenza A virus (H1N1) infection complicated with pneumonia, of whom 5 patients had atelectasis, 2 had pneumothorax, 1 had pneumomediastinum, 1 had parapneumonic effusion, 2 patients were suspected of foreign body aspiration. Seven cases were admitted to an ICU, 5 patients developed respiratory failure, and 3 patients required mechanical ventilation. Flexible bronchoscopy and bronchial lavage was performed in all cases and showed bronchial cast. Histological examination of the bronchial cast revealed a fibrinous material containing large quantity of eosinophils, neutrophils, and lymphocytes in 7 patients, fibrinous material and necrotic material without inflammatory cells in 1 patient. After the bronchial cast was removed, all patients were improved greatly, no patients died.
CONCLUSIONPlastic bronchitis is a life-threatening complication associated with 2009 influenza A (H1N1) virus infection in children. In children with rapid and progressive respiratory distress with lung atelectasis or consolidation on chest radiograph, plastic bronchitis should be considered. Bronchoscopic extraction of casts should be carried out early.
