scholarly journals Clinical Features of Plastic Bronchitis Related to Respiratory Tract Infection in 269 Children

2022 ◽  
Author(s):  
xiaojian cui ◽  
Wei Guo ◽  
Lihua Zhao ◽  
Tongqiang Zhang ◽  
Jiafeng Zheng ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Clinical Features ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Fiberoptic Bronchoscopy ◽  
Plastic Bronchitis ◽  
D Dimer

Abstract Background. Plastic bronchitis (PB) is a pulmonary disease characterized by the formation of bronchial casts (BCs) that lead to airway blockage. The study aimed to investigate the clinical features of PB related to respiratory tract infection. Methods. A retrospective analysis was performed on data collected over a 5-year period (from January 2015 to December 2019) on children with PB (n=269). The clinical manifestations, laboratory data, imaging findings and management, were investigated. The single fiberoptic bronchoscopy (FOB, n=144) and multiple-treatment groups (n=125) were compared.Results. A total of 269 PB children were included with a mean age of 6.7 ± 2.8 years. The majority of cases (n=241, 89.6%) were diagnosed with Mycoplasma pneumonia (MP) infection. The mean duration of fever and hospitalization was 10.6 ± 3.7 and 9.3 ± 3.2 days, respectively. All patients presented with cough and fever, 62 (23.0%) suffered from hypoxemia, and 144 (53.5%) had extrapulmonary complications. Higher levels of ESR, CRP, PCT, IL-6, LA, LDH, FER and D-dimer were observed. CT findings, including pulmonary consolidation, segmental or lobar atelectasis, pleural effusion and pleural thickening, were observed in 97.4%, 46.5%, 47.9% and 63.2% of cases, respectively. Furthermore, multivariate logistic regression analysis showed that N% >75.5%, LDH >598.5U/L, and D-dimer>1.2mg/L were independent risk factors for multiple therapeutic FOB. Conclusions. MP is a major pathogen responsible for PB in children. Patients with PB are more likely to experience persistent fever and excessive inflammation and have severe radiological findings. FOB is an effective treatment for patients with PB, and children may require multiple FOBs for cast removal. N% >75.5%, LDH >598.5U/L and D-dimer > 1.2mg/L are independent predictors of multiple FOB treatment.

scholarly journals Clinical features and predictors of multiple bronchoscopy therapy of plastic bronchitis in children

2021 ◽  
Author(s):  
Tongqiang Zhang ◽  
Lihua Zhao ◽  
Jiafeng Zheng ◽  
Linsheng Zhao ◽  
Xiaojian Cui ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Fiberoptic Bronchoscopy ◽  
Plastic Bronchitis ◽  
Radiological Findings ◽  
Pleural Thickening ◽  
Mycoplasma Pneumonia ◽  
Flexible Fiberoptic Bronchoscopy ◽  
The Mean

Background. To analyze the clinical features of children with plastic bronchitis (PB) and identify the risk factors of multiple flexible fiberoptic bronchoscopy (FOB) therapy. Methods. Retrospective analysis was performed on 269 PB children from 2016 to 2019, 144 cases were in single FOB group, 125 cases were in the multiple FOB group. The clinical manifestations, laboratory datas, imaging findings and management were investigated. The different features were compared between the single FOB group and multiple FOB group. Results. A total of 269 PB children were collected with a mean age of 6.7 ± 2.8 years. 257 (95.5%) cases were diagnosed as Mycoplasma pneumonia (MP) infection. The mean duration of fever was 10.6 ± 3.7 days. All the patients presented with fever, and 62 (23.0%) suffered from hypoxemia, 144 (53.5%) had extrapulmonary complications. Higher levels of ESR, CRP, PCT, IL-6, LA, LDH, FER and D-dimer were observed. The proportion of pulmonary consolidation, segmental or lobar atelectasis, pleural effusion and pleural thickening were 97.4%, 46.5%, 47.9% and 63.2%, respectively. Furthermore, multivariate logistic regression analysis showed that N% >75.5%, LDH >598.5U/L, and D-dimmer>0.45mg/L were independent isk factors for multiple FOB therapy. Conclusions. MP is a significant pathogen of PB in children. Patients with PB are more likely to suffer from persistent fever, excessive inflammation and severe radiological findings. N% >75.5%, LDH >598.5U/L and D-dimmer > 0.45mg/L may be predictors of multiple FOB treatment.

scholarly journals Clinical Features and High-risk Factors Prediction of Multiple Fiberoptic Bronchoscopy Therapy of Plastic Bronchitis in 269 Children

2021 ◽  
Author(s):  
Tongqiang Zhang ◽  
Lihua Zhao ◽  
Jiafeng Zheng ◽  
Linsheng Zhao ◽  
Xiaojian Cui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Features ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Fiberoptic Bronchoscopy ◽  
Plastic Bronchitis ◽  
Pleural Thickening ◽  
High Risk Factors ◽  
Mycoplasma Pneumonia ◽  
Flexible Fiberoptic Bronchoscopy

Abstract Background. To analyze the clinical features of children with plastic bronchitis (PB) and identify the risk factors of multiple flexible fiberoptic bronchoscopy (FOB) therapy.Methods. Retrospective analysis was performed on 269 PB children from 2016 to 2019, 144 cases were in single FOB group, 125 cases were in the multiple FOB group. The clinical manifestations, laboratory datas, imaging findings and management were investigated. The different features were compared between the single FOB group and multiple FOB group.Results. A total of 269 PB children were collected with a mean age of 6.7 ± 2.8 years. 257 (95.5%) cases were diagnosed as Mycoplasma pneumonia (MP) infection. The mean duration of fever was 10.6 ± 3.7 days. All the patients presented with fever, and 62 (23.0%) suffered from hypoxemia, 144 (53.5%) had extrapulmonary complications. Higher levels of ESR, CRP, PCT, IL-6, LA, LDH, FER and D-dimer were observed. The proportion of pulmonary consolidation, segmental or lobar atelectasis, pleural effusion and pleural thickening were 97.4%, 46.5%, 47.9% and 63.2%, respectively. Furthermore, multivariate logistic regression analysis showed that N% >75.5%, LDH >598.5U/L, and D-dimmer>0.45mg/L were independent isk factors for multiple FOB therapy. Conclusions. MP is a significant pathogen of PB in children. Patients with PB are more likely to suffer from persistent fever, excessive inflammation and severe radiological findings. N% >75.5%, LDH >598.5U/L and D-dimmer > 0.45mg/L may be predictors of multiple FOB treatment.

scholarly journals Add-on treatment with nebulized hypertonic saline in a child with plastic bronchitis after the Glenn procedure

2014 ◽  
Vol 40 (1) ◽  
pp. 82-85 ◽  
Author(s):  
Grzegorz Lis ◽  
Ewa Cichocka-Jarosz ◽  
Urszula Jedynak-Wasowicz ◽  
Edyta Glowacka
Keyword(s):  
Cardiac Surgery ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Fiberoptic Bronchoscopy ◽  
Mortality Rates ◽  
Univentricular Heart ◽  
Plastic Bronchitis ◽  
Nacl Solution ◽  
Left Bronchus ◽  
Glenn Procedure

Plastic bronchitis (PB), although a rare cause of airway obstruction, has mortality rates up to 50% in children after Fontan-type cardiac surgery. We present the case of an 18-month-old female patient with PB following pneumonia. At 6 months of age, the patient underwent the Glenn procedure due to functionally univentricular heart. Fiberoptic bronchoscopy revealed complete blockage of the left bronchus by mucoid casts. Pharmacotherapy consisted of glucocorticosteroids, azithromycin, and enalapril maleate. The child also received nebulized 3% NaCl solution, which proved to be beneficial. In children submitted to Fontan-type procedures, physicians must be alert for PB, which can be triggered by respiratory tract infection.

scholarly journals Identifying clinical factors associated with Fulminant Mycoplasma pneumoniae pneumonia in children

2020 ◽  
Author(s):  
yaoyao ling ◽  
Tongqiang Zhang ◽  
wei guo ◽  
Zhenli Zhu ◽  
Jiao Tian ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Mycoplasma Pneumoniae ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Clinical Factors ◽  
Radiological Findings ◽  
Related Factors ◽  
Mycoplasma Pneumoniae Pneumonia ◽  
D Dimer

Abstract BACKGROUND: Analyze the clinical characteristics of Fulminant Mycoplasma pneumoniae pneumonia (FMPP), and identify the related factors predicting FMPP.METHODS: A retrospective case-control study was performed on 345 children with Mycoplasma pneumoniae pneumonia (MPP) hospitalized in our hospital from January 2017 to June 2019. The clinical features, laboratory data and radiological findings were compared between the FMPP group, refractory Mycoplasma pneumoniae pneumonia (RMPP)group and general Mycoplasma pneumoniae pneumonia (GMPP) group. RESULTS: FMPP patients (n=69) had a higher incidence of extra-pulmonary complications and more serious radiological findings(P<0.05), besides the days of fever and the days in the hospitals were longer. FMPP patients also need more complicated treatments(P<0.05). Meanwhile, the levels of white blood cell count(WBC), C-reactive protein(CRP), lactic dehydrogenase (LDH), interleukin (IL)-6, ferritin, D-dimer, fibrinogen(FG), alanine aminotransferase(ALT) and the percentage of neutrophils in the FMPP group were significantly higher than those in the RMPP group and the GMPP group (P<0.05). In ROC curve analysis, the percentage of neutrophils, WBC, CRP, LDH, IL-6, ferritin, D-dimer and ALT were contributed to identify FMPP patients. Multivariate logistic regression analysis showed that ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion have significant predictive effects on the early diagnosis of FMPP (P<0.01).CONCLUSION: FMPP patients presented more serious clinical manifestations. Ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion were clinical factors for FMPP.

scholarly journals Clinical characteristics and risk factors of Fulminant Mycoplasma pneumoniae pneumonia in children

2020 ◽  
Author(s):  
yaoyao ling ◽  
Tongqiang Zhang ◽  
Zhenli Zhu ◽  
Jiao Tian ◽  
yongsheng xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Mycoplasma Pneumoniae ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Radiological Findings ◽  
Mycoplasma Pneumoniae Pneumonia ◽  
D Dimer

Abstract BACKGROUND: Analyze the clinical characteristics of Fulminant Mycoplasma pneumoniae pneumonia (FMPP), and explore the related factors predicting FMPP. METHODS: A retrospective case-control study was performed on 345 children with Mycoplasma pneumoniae pneumonia (MPP) hospitalized in our Hospital from January 2017 to June 2019. The clinical features, laboratory data and radiological findings were compared between the FMPP group, refractory Mycoplasma pneumoniae pneumonia (RMPP)group and general Mycoplasma pneumoniae pneumonia (GMPP) group. RESULTS: FMPP patients (n=69) had more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings(P<0.05). And the days of fever and the days in hospital were longer, and FMPP patients also need more complicated treatments(P<0.05). Meanwhile, the levels of white blood cell count(WBC) ,C-reactive protein(CRP), lactic dehydrogenase (LDH), interleukin (IL)-6,ferritin, D-dimer, fibrinogen(FG),alanine aminotransferase(ALT) and the percentage of neutrophils in the FMPP group were significantly higher than those in the RMPP group and the GMPP group (both P<0.05). In ROC curve analysis, the percentage of neutrophils, WBC, CRP, LDH, IL-6, ferritin, D-dimer and ALT were contributed to identify FMPP patients. Multivariate logistic regression analysis showed that ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion had significant predictive effects on the early diagnosis of FMPP (P<0.01). Conclusion: FMPP patients presented more serious clinical manifestations. Ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion were high risk factors for FMPP.

scholarly journals Comprehensive analyses of immunoglobulin proteome and clinical variables identify biomarkers to predict mortality in patients with influenza-associated lower respiratory tract infection

2020 ◽  
Author(s):  
Fei Teng ◽  
Dan Wang ◽  
Xiao-Mei Zhang ◽  
Jian-Hua Liu ◽  
Jia-Yu Dai ◽  
...  
Keyword(s):  
T Cell ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Prediction Model ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Oxygenation Index ◽  
Clinical Variables ◽  
D Dimer

Abstract Background: Influenza-associated lower respiratory tract infection (I-LRTI) brings a heavy clinical burden, and clinicians lack an effective prognostic evaluation system to control disease progression. Methods: This was a prospective, observational study, and the endpoint was 28-day mortality. Plasma microarrays were used for quantitative analysis of immunoglobulin (Ig) and its subclasses. Prognostic factors from Ig and clinical variables in the patients with I-LRTI were identified to create a prediction model. Results: To address this issue, we prospectively and observationally studied the difference of immunoglobulin proteome and clinical variables between survivors and non-survivals in 107 patients with influenza-associated lower respiratory tract infection (I-LRTI) selected from four hospitals affiliated to Capital Medical University. The results identified 17 variables with significant or marginally statistical differences by univariate analysis, including lymphocyte count (LY), monocytes count (MO), CD3 + CD4 + T-cell count, CD3 + CD8 + T-cell count, IgA, IgA1, IgG2, IgG4, CRP, PCT, D-dimer, oxygenation index, glycosylated hemoglobin, lactic acid (LAC), base excess of blood, lactic dehydrogenase, and α-hydroxybutyrate dehydrogenase. Furthermore, we analyzed the correlations of all the variables by hierarchical clustering analysis in which different functional modules were formed between survival and non-survival groups that are associated with the immunity and severe infection. At last, we built a prediction model with nine variables (D-dimer, days from onset to ED, IgA, IgG2, LAC, LY, MO, Staphylococcus aureus co-infection and age), with which the AUC value of 0.810 (95% CI 0.755-0.839) was achieved with the evaluation of LOO cross validation. The predictive model was further validated by disease severity evaluation. Conclusion: Lethal bacterial (especially S. aureus ) co-infection was associated with cellular immunity, oxygenation index, HbA1C and age. The combined prediction model with D-dimer, Days from onset to ED, IgA, IgG2, LAC, LY, MO, S.aureus co-infection and age demonstrate the predictive mortality powerfully in patients with I-LRTI.

scholarly journals Lower Respiratory Tract Infection and Genus Enterovirus in Children Requiring Intensive Care: Clinical Manifestations and Impact of Viral Co-Infections

Viruses ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2059
Author(s):  
Daniel Penela-Sánchez ◽  
Jon González-de-Audicana ◽  
Georgina Armero ◽  
Desiree Henares ◽  
Cristina Esteva ◽  
...  
Keyword(s):  
Intensive Care ◽  
Tract Infection ◽  
Young Children ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Invasive Mechanical Ventilation ◽  
Clinical Manifestations ◽  
Clinical Severity

Infection by rhinovirus (RV) and enterovirus (EV) in children ranges from asymptomatic infection to severe lower respiratory tract infection (LRTI). This cohort study evaluates the clinical impact of RV/EV species, alone or in codetection with other viruses, in young children with severe LRTI. Seventy-one patients aged less than 5 years and admitted to the Paediatric Intensive Care Unit (PICU) of a reference children’s hospital with RV or EV (RV/EV) LRTI were prospectively included from 1/2018 to 3/2020. A commercial PCR assay for multiple respiratory pathogens was performed in respiratory specimens. In 22/71, RV/EV + respiratory syncytial virus (RSV) was found, and 18/71 had RV/EV + multiple viral detections. Patients with single RV/EV detection required invasive mechanical ventilation (IMV) as frequently as those with RSV codetection, whereas none of those with multiple viral codetections required IMV. Species were determined in 60 samples, 58 being RV. No EV-A, EV-C, or EV-D68 were detected. RV-B and EV-B were only found in patients with other respiratory virus codetections. There were not any associations between RV/EV species and severity outcomes. To conclude, RV/EV detection alone was observed in young children with severe disease, while multiple viral codetections may result in reduced clinical severity. Differences in pathogenicity between RV and EV species could not be drawn.

scholarly journals Epidemiology of Influenza in Patients with Acute Lower Respiratory Tract Infection in South of Iran (2015-2016)

2019 ◽  
Vol 36 (1) ◽  
pp. 27-37 ◽  
Author(s):  
Vahid Rahmanian ◽  
Masihollah Shakeri ◽  
Heshmatollah Shakeri ◽  
Abdolreza Sotoodeh Jahromi ◽  
Alireza Bahonar ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Multivariate Logistic Regression Analysis ◽  
Clinical Aspects ◽  
Tract Infections ◽  
Underlying Diseases

Summary Influenza is of particular importance because of the pace of epidemics, the extent and number of infected people, and the severity of the side effects. The aim of this study was to investigate the epidemiological and clinical aspects of this disease during the last epidemic in southern Iran. The present cross-sectional study was performed on the basis of secondary data analysis and information in medical records of patients with acute lower respiratory system infection in hospitals affiliated to Jahrom University of Medical Sciences. Data were analyzed by SPSS 18 using descriptive statistics, Chi-square test and logistic regression at 0.05 significance level. From 1st September 2015 to 20th March 2016, 108 patients with acute lower respiratory tract infection with a mean age of 42.92 ± 19.65 years were admitted to Jahrom hospitals, of which 43 were diagnosed with definite influenza, all of which (100%) had H1N1 type A influenza. There were eight deaths in all, of which five were positive for H1N1, and of these five cases, three cases had delayed diagnosis and treatment, and four cases had underlying diseases. The results of multivariate logistic regression analysis showed a significant relationship between positive H1N1 cases and history of contact with definite influenza, traveling abroad, and clinical symptoms of chills (p < 0.05). The results of this study showed that 39.81% of the patients with acute lower respiratory tract infections suffered from influenza. Furthermore, the delayed treatment and the underlying diseases were the most important cause of death.

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