Clinical analysis of plastic bronchitis caused by adenoviral pneumonia in 9 children / 中华实用儿科临床杂志

ABSTRACT

Objective:To analyze the clinical characteristics of plastic bronchitis(PB) caused by adenoviral pneumonia.Methods:The clinical data of 9 children diagnosed with PB caused by adenoviral pneumonia in the Xiamen Children′s Hospital from March to June 2019 were retrospectively analyzed.Results:Among the 9 children(3 boys and 6 girls), 6 patients were under 2 years old.All patients had fever, cough and dyspnea, with the duration of 6-15 days.Laboratory tests showed that procalcitonin(PCT) and increased in 7 children, D-dimer, fibrinogen degraded product (FDP) were increased in 6 children, and lactate dehydrogenase(LDH) was increased in 8 children.Chest imaging examination showed atelectasis with pulmonary consolidation in 9 children, including 4 cases of left lower lobe consolidation, 2 cases of right lower lobe consolidation, 1 case of right upper lung consolidation, and 2 cases of consolidation of multiple lungs in the lower lobe.Seven cases had pleural effusion.By fiberoptic bronchoscopy, the bronchial plastics was removed from the left lower lobe in 5 patients, from the right lower lobe in 3 patients, and from the right upper lobe in 1 patient on the 6th to 20 th day of the disease.Eight patients were discharged after clinical cure.One patient deve-loped multiple organ failure, and discharged from the hospital after the family members gave up rescue.The death was reported by the telephone follow-up death. Conclusions:PB is considered when patients with adenovirus pneumonia have persistent high fever, shortness of breath, dyspnea, pulmonary consolidation/lung atelectasis, increased PCT and LDH, hypercoagulability of the blood, and pleural effusion.Fiberoptic bronchoscopy plays an important role in confirming the diagnosis and improving the prognosis.