Clinical Analysis of Atelectasis Caused by Influenza A in Xiamen Children’s Hospital Between 2017 and 2019
Abstract Background: We aimed to analyze the clinical characteristics of pediatric patients with atelectasis caused by influenza A to provide a reference for reasonable clinical diagnosis and treatment. Methods: We included 79 pediatric patients with atelectasis caused by influenza A diagnosed at Xiamen Children’s Hospital between January 1, 2017 and December 31, 2019. We analyzed their epidemiological characteristics, clinical manifestations, imaging changes, diagnosis, treatment process, and outcomes. Results: Among the 79 included patients (males: 52; females: 27), 70 (88.61%) were > 6 years-old and 54 (68.35%) had atelectasis onset during winter. A majority experienced fever and cough. Among them, 44, 16, 21, 14, and 12 had normal/decreased white blood cells, elevated procalcitonin, abnormal hepatic function, abnormal myocardial enzyme spectrum, Mycoplasma pneumoniae infection, and Streptococcus pneumoniae infection, respectively. Seventy-nine patients presented different atelectasis degrees, including 16 and 29 with atelectasis in the right and left lung, respectively, while 34 had multiple consolidations and atelectasis lesions in both lungs. Fiberoptic bronchoscopy examination of 57 cases revealed mucus plug blockage in 6 cases; among them, 2 cases underwent bronchial cast removal. All patients received oseltamivir or peramivir for antiviral treatment and antibacterial treatment for complicated bacterial infection. All the patients recovered and were eventually discharged. Post-discharge follow-up showed that 77 cases were cured while 2 experienced recurrent respiratory tract infections and post-activity shortness of breath with chest computer tomography showing mosaic perfusion. Conclusion There is a high incidence of atelectasis caused by influenza A during winter among children aged < 6 years. The main manifestations are fever (mostly hyperpyrexia) and cough. Chest imaging shows consolidation and atelectasis occurring in any lung lobe. Some patients present multiple consolidations and atelectasis lesions complicated by mucus plugs or bronchial casts. Timely fiberoptic bronchoscopy and alveolar lavage could shorten the disease course and improve the prognosis.