[Plastic bronchitis associated with severe influenza A (H1N1) in children: a case report and review of the literature].

ABSTRACT

OBJECTIVE: to improve understanding of the pathological and clinical features, diagnosis and treatment of plastic bronchitis associate with influenza A (H1N1). METHODS: one case of plastic bronchitis associated with influenza A (H1N1) diagnosed and treated in our hospital in January 2010 was reported and 19 cases of plastic bronchitis reported in the literature were reviewed. RESULTS: we describe a 5-year-old Chinese Japanese boy presenting with cough for 2 days, gasping and fever for 1 day was admitted. Left lung atelectasis and pneumothorax were found on chest X-ray examination. Pathologically, plastic bronchitis was diagnosed after the endogenous foreign body was extracted by bronchoscopy and classified as type 1 cast. In addition, influenza A (H1N1) was confirmed by the swabs which showed positive for H1N1 nucleic acid. The condition was controlled and the patient was cured and discharged after 16-days' treatment with antiviral therapy, low-dose corticosteroids, and antibiotics. CONCLUSION: plastic bronchitis associated with influenza A (H1N1) is a rare life-threatening disorder. The diagnosis could be made based on pathological findings of the bronchial casts as well as the positive H1N1 nucleic acid detection. Bronchoscopic extraction of casts in plastic bronchitis is not only useful for early diagnosis but an effective therapeutic modality for the disease. Influenza A (H1N1) may be a cause of plastic bronchitis.