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Li L, Wang D, Yang R, Liao X, Wu L. Application of decision tree model in diagnosis of mycoplasma pneumoniae pneumonia with plastic bronchitis. Ital J Pediatr 2025; 51:95. [PMID: 40128882 PMCID: PMC11934725 DOI: 10.1186/s13052-025-01934-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2024] [Accepted: 03/09/2025] [Indexed: 03/26/2025] Open
Abstract
BACKGROUND To establish a decision tree model of Mycoplasma pneumoniae pneumonia(MPP) complicated with plastic bronchitis(PB) in children, and to explore the application value of decision tree model in the auxiliary diagnosis of children. METHODS A retrospective study was conducted to collect the clinical data of 214 children who met the admission criteria in Fujian Children's Hospital from June 2022 to June 2024, and they were divided into plastic bronchitis group (n = 66) and non-plastic bronchitis group (n = 148). Using R language, 70% of the data from each group of patients was randomly selected for training the model using decision tree algorithm analysis, thus generating a clinical diagnostic decision tree for Mycoplasma pneumoniae (MP) combined with PB. The generated decision tree model was validated on the validation sample dataset and the detection effect value of the model was calculated. RESULT In this study, a total of 22 indicators were employed to build the decision tree diagnostic model. Univariate statistical analysis was carried out prior to the model construction, and it was discovered that the differences of 13 indicators between the molded group and the non-molded group were statistically significant. A decision tree model with D-dimer ≥ 1.7ug/mL, C-reactive protein ≥ 15 mg/L, drug resistance or not, and serum ferritin<137 mg/L was constructed in the training sample dataset of the molded group and the non-molded group. The sensitivity of the decision tree model was 0.884, which was verified in the dataset of the remolded group and the non-molded group. The specificity was 0.727, and the area under the receiver operating characteristic curve was 0.831. CONCLUSION Decision tree model can provide reference for the application of auxiliary diagnosis in children with mycoplasma pneumoniae pneumonia complicated with plastic bronchitis. The model has good discriminative ability in general, and is worthy of clinical application and further study.
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Affiliation(s)
- Lin Li
- Department of Infectious Diseases, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), National Regional Medical Center, Fujian Medical University, Fuzhou, 350014, PR China
| | - Dong Wang
- Department of Infectious Diseases, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), National Regional Medical Center, Fujian Medical University, Fuzhou, 350014, PR China
| | - Rongrong Yang
- Department of Infectious Diseases, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), National Regional Medical Center, Fujian Medical University, Fuzhou, 350014, PR China
| | - Xing Liao
- Department of Infectious Diseases, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), National Regional Medical Center, Fujian Medical University, Fuzhou, 350014, PR China
| | - Ling Wu
- Department of Infectious Diseases, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), National Regional Medical Center, Fujian Medical University, Fuzhou, 350014, PR China.
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Yang L, Zhang Y, Shen C, Lu Z, Hou T, Niu F, Liu R, Ning J, Wang Y. Clinical features and risk factors of plastic bronchitis caused by Mycoplasma pneumoniae pneumonia in children. BMC Pulm Med 2023; 23:468. [PMID: 37996853 PMCID: PMC10668422 DOI: 10.1186/s12890-023-02766-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND We analyzed the clinical characteristics of children with plastic bronchitis (PB) caused by Mycoplasma pneumoniae (MP) and explored its risk factors. METHODS We prospectively analyzed clinical data of children with MP pneumonia (MPP) treated with fiberoptic bronchoscopy (FB). Patients were classified into a PB and non-PB group. General information, clinical manifestations, laboratory tests, results of computed tomography scan, and FB findings were compared between groups. We conducted statistical analysis of risk factors for developing PB. RESULTS Of 1169 children who had MPP and were treated with FB, 133 and 1036 were in the PB and non-PB groups, respectively. There were no significant differences in sex, age, and incident season between groups (P > 0.05). The number of children in the PB group decreased during the COVID-19 pandemic. Compared with children in the non-PB group, those in the PB group had longer duration of hospitalization, increased levels of neutrophil (N), C-reactive protein (CRP), procalcitonin (PCT), D-dimer, lactate dehydrogenase (LDH), alanine transaminase (ALT) and aspartate transaminase (AST); lower levels of lymphocyte (L) and platelet (PLT); and higher incidence of lack of appetite, decreased breath sounds, single lobar infiltrate, pleural effusion, pericardial effusion, mucosal erosion and/or necrosis, and bronchial embolization. L levels and pleural effusion were identified as risk factors in multivariate logistic regression. CONCLUSIONS Children with PB caused by MPP had a strong and local inflammatory response. L levels and pleural effusion were independent risk factors of PB with MPP in children. Our findings will help clinicians identify potential PB in pediatric patients for early and effective intervention.
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Affiliation(s)
- Lei Yang
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China
- Postdoctoral Mobile Station of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250399, China
| | - Yuyan Zhang
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China
| | - Changqing Shen
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China
| | - Zhouhua Lu
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China
| | - Tongshu Hou
- The Second Clinical Medical College, Binzhou Medical University, Yantai, Shandong, 264100, China
| | - Fenghai Niu
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China
| | - Ruihan Liu
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China.
- Postdoctoral Mobile Station of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250399, China.
| | - Jun Ning
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China.
| | - Yuzhong Wang
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China.
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Huang F, Gu W, Diwu J, Zhang X, He Y, Zhang Y, Chen Z, Huang L, Wang M, Dong H, Wang S, Wang Y, Zhu C, Hao C. Etiology and clinical features of infection-associated plastic bronchitis in children. BMC Infect Dis 2023; 23:588. [PMID: 37679703 PMCID: PMC10486060 DOI: 10.1186/s12879-023-08529-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/10/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVE To investigate the etiological characteristics of plastic bronchitis (PB) caused by pulmonary infections in children and to identify any differences in the clinical features of PB cases caused by different pathogens. METHOD We collected data on children diagnosed with PB and admitted to the Respiratory Department at Soochow University Children's Hospital between July 2021 and March 2023 utilizing electronic bronchoscopy. We analyzed clinical characteristics and the species of pathogens causing the illness in these children. RESULT A total of 45 children were enrolled. The main clinical symptoms observed were cough (100%), fever (80%), shortness of breath (28.9%), and wheezing (20.0%). Pathogens were identified in 38 (84.4%) patients. Mycoplasma pneumoniae (MP) had the highest detection rate at 53.3%, followed by the Boca virus at 26.7%. MP-induced PB typically occurs in older children with an average age of 7.46 ± 2.36 years, with the main symptoms including high fever (85.7%) and local hyporespiration (42.9%). In contrast, Boca virus-induced PB tends to occur in younger children, with the main symptoms of moderate fever (54.5%), and wheezing (54.5%). The MP group exhibited a higher incidence of both internal and external pulmonary complications, including pleural effusion (42.9%), elevated aspartate aminotransferase (52.4%), lactic dehydrogenase (76.2%), and D-D dimer (90.5%). Conversely, the Boca virus group primarily showed pulmonary imaging of atelectasis (81.8%), with no pleural effusion. The average number of bronchoscopic interventions in the MP group was 2.24 ± 0.62, which was significantly higher than that required in the Boca virus group (1.55 ± 0.52). During the second bronchoscopy, 57.1% of children in the MP group still had visible mucus plugs, while none were observed in the Boca virus group. CONCLUSION MP and Boca virus are the primary pathogens responsible for PB among children. The clinical manifestations of PB typically vary significantly based on the pathogen causing the condition.
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Affiliation(s)
- Feng Huang
- Department of Respiration, Children’s Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003 China
| | - Wenjing Gu
- Department of Respiration, Children’s Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003 China
| | - Jianfeng Diwu
- Department of Pediatric, Xunyi County Hospital, Xianyang, 711300 China
| | - Xinxing Zhang
- Department of Respiration, Children’s Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003 China
| | - Yanyu He
- Department of Respiration, Children’s Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003 China
| | - Youjian Zhang
- Department of Clinical laboratory, Children’s Hospital of Soochow University, Suzhou, 215003 China
| | - Zhengrong Chen
- Department of Respiration, Children’s Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003 China
| | - Li Huang
- Department of Respiration, Children’s Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003 China
| | - Meijuan Wang
- Department of Respiration, Children’s Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003 China
| | - Heting Dong
- Department of Respiration, Children’s Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003 China
| | - Shanshan Wang
- Department of Pediatric, Xunyi County Hospital, Xianyang, 711300 China
| | - Yuqing Wang
- Department of Respiration, Children’s Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003 China
| | - Canhong Zhu
- Department of Respiration, Children’s Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003 China
| | - Chuangli Hao
- Department of Respiration, Children’s Hospital of Soochow University, No. 303 Jing De Road, Suzhou, 215003 China
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Zhang H, Yang J, Zhao W, Zhou J, He S, Shang Y, Cheng Q. Clinical features and risk factors of plastic bronchitis caused by refractory Mycoplasma pneumoniae pneumonia in children: a practical nomogram prediction model. Eur J Pediatr 2023; 182:1239-1249. [PMID: 36633659 PMCID: PMC10023623 DOI: 10.1007/s00431-022-04761-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 01/13/2023]
Abstract
Early assessment of refractory Mycoplasma pneumoniae pneumonia (RMPP) with plastic bronchitis (PB) allows timely removal of casts using fiberoptic bronchoscopic manipulation, which relieves airway obstruction and limit sequelae development. This study aimed to analyze clinical data for risk factors and develop a nomogram for early predictive evaluation of RMPP with PB. The clinical data of 1-14 year-old patients with RMPP were retrospectively analyzed. Patients were classified into a PB or non-PB group. The general characteristics, clinical symptoms, laboratory test results, imaging findings, and microscopic changes of the two groups were compared. A statistical analysis of the risk factors for developing PB was performed, and a nomogram model of risk factors was constructed. Of 120 patients with RMPP included, 68 and 52 were in the non-PB and PB groups, respectively. Using multivariate logistic regression analysis, fever before bronchoscopy, extrapulmonary complications, pleural effusion, cough duration, and lactate dehydrogenase (LDH) levels were identified as risk factors. A nomogram was constructed based on the results of the multivariate analysis. The area under the receiver operating characteristic curve value of the nomogram was 0.944 (95% confidence interval: 0.779-0.962). The Hosmer-Lemeshow test displayed good calibration of the nomogram (p = 0.376, R2 = 0.723). CONCLUSION The nomogram model constructed in this study based on five risk factors (persistent fever before bronchoscopy, extrapulmonary complications, pleural effusion, cough duration, and LDH levels) prior to bronchoscopy can be used for the early identification of RMPP-induced PB. WHAT IS KNOWN • Refractory Mycoplasma pneumoniae pneumonia (RMPP) in children has been increasingly reported and recognized, which often leads to serious complications. • Plastic bronchitis (PB) is considered to be one of the causes of RMPP, and bronchoscopic treatment should be improved as soon as possible to remove plastic sputum thrombus in bronchus. WHAT IS NEW • This study determined the risk factors for RMPP-induced PB. • The nomogram model constructed in this study prior to bronchoscopy can be used for the early identification of RMPP-induced PB, which facilitate the early bronchoscopic removal of casts, thereby promoting recovery and reducing cases with poor RMPP prognosis.
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Affiliation(s)
- Han Zhang
- Department of Pediatrics, Shengjing Hospital of China Medical University, 36Th Sanhao Street, Heping District, Shenyang, Liaoning, 110004, People's Republic of China
| | - Jingjing Yang
- Department of Pediatrics, Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, Jilin, 130021, China
| | - Wenqi Zhao
- Department of Pediatrics, Shengjing Hospital of China Medical University, 36Th Sanhao Street, Heping District, Shenyang, Liaoning, 110004, People's Republic of China
| | - Jing Zhou
- Department of Pneumology, Xinmin People's Hospital, Shenyang, 110300, Liaoning, China
| | - Shuangyu He
- Department of Pediatrics, Shengjing Hospital of China Medical University, 36Th Sanhao Street, Heping District, Shenyang, Liaoning, 110004, People's Republic of China
| | - Yunxiao Shang
- Department of Pediatrics, Shengjing Hospital of China Medical University, 36Th Sanhao Street, Heping District, Shenyang, Liaoning, 110004, People's Republic of China
| | - Qi Cheng
- Department of Pediatrics, Shengjing Hospital of China Medical University, 36Th Sanhao Street, Heping District, Shenyang, Liaoning, 110004, People's Republic of China.
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Ntiamoah P, Mukhopadhyay S, Ghosh S, Mehta AC. Recycling plastic: diagnosis and management of plastic bronchitis among adults. Eur Respir Rev 2021; 30:210096. [PMID: 34407979 PMCID: PMC9489172 DOI: 10.1183/16000617.0096-2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/26/2021] [Indexed: 11/05/2022] Open
Abstract
Plastic bronchitis is a rare, underdiagnosed and potentially fatal condition. It is characterised by the formation and expectoration of branching gelatinous plugs that assume the shape of the airways. These airway plugs differ from the allergic mucin that characterises allergic bronchopulmonary aspergillosis and mucoid impaction of the bronchi. Plastic bronchitis is most often encountered in the paediatric population following corrective cardiac surgery, such as the Fontan procedure. It also occurs in adults. Plastic bronchitis in adults is rare, heterogeneous in its aetiology, and can lead to respiratory distress or even life-threatening airway obstruction. Plastic bronchitis in adulthood should not be overlooked, particularly in patients with chronic inflammatory lung diseases. This review presents current understanding of the presentation, aetiology, pathogenesis, pathology and management of plastic bronchitis in adults.
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Affiliation(s)
- Prince Ntiamoah
- Dept of Pulmonary and Critical Care Medicine, Cleveland Clinic, Cleveland, OH, USA
| | | | - Subha Ghosh
- Diagnostic Radiology, Cleveland Clinic, Cleveland, OH, USA
| | - Atul C Mehta
- Dept of Pulmonary and Critical Care Medicine, Cleveland Clinic, Cleveland, OH, USA
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Ogiwara M, Ichinose M, Nishino Y, Ozaki M, Miyahara T. A case of plastic bronchitis after mitral valve surgery in an adult. Clin Case Rep 2021; 9:2122-2124. [PMID: 33936650 PMCID: PMC8077369 DOI: 10.1002/ccr3.3961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/31/2021] [Accepted: 02/08/2021] [Indexed: 11/09/2022] Open
Abstract
Plastic bronchitis is a rare and fatal disease that is characterized by the presence of long dendritic bronchial casts in the airway. It is encountered most frequently in children with congenital heart disease after correction surgery. We reported a case of plastic bronchitis after mitral valve surgery in a 70-year-old woman.
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Affiliation(s)
- Masanori Ogiwara
- Department of Cardiovascular SurgeryShowa General HospitalTokyoJapan
| | - Maki Ichinose
- Department of AnesthesiologyShowa General HospitalTokyoJapan
| | - Yoshifumi Nishino
- Department of Cardiovascular SurgeryShowa General HospitalTokyoJapan
| | - Masahiko Ozaki
- Department of Cardiovascular SurgeryShowa General HospitalTokyoJapan
| | - Takuya Miyahara
- Department of Cardiovascular SurgeryShowa General HospitalTokyoJapan
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Liu YR, Ai T. Plastic bronchitis associated with Botrytis cinerea infection in a child: A case report. World J Clin Cases 2020; 8:5019-5024. [PMID: 33195676 PMCID: PMC7642555 DOI: 10.12998/wjcc.v8.i20.5019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/01/2020] [Accepted: 08/29/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Plastic bronchitis (PB) frequently occurs in children after the surgical repair of congenital cardiac defects or in the presence of inflammatory or allergic diseases of the lung. Accurate epidemiological data of this condition are still lacking.
CASE SUMMARY A 5-year-old boy, with a clear medical history, presented to our hospital with persistent cough and pneumonia with segmental atelectasis on chest computerized tomography. He showed no significant improvement after 1 wk of amoxicillin-clavulanate potassium treatment. Bronchial casts were extracted using flexible bronchoscopy. Pathological examination of the dendritic cast confirmed the diagnosis of type I PB. Botrytis cinerea was detected by next-generation sequencing of the bronchoalveolar lavage fluid. After the removal of the airway obstruction and fluconazole treatment, the patient recovered and was discharged 14 d after admission without the recurrence of cough.
CONCLUSION Botrytis cinerea pneumonia should be considered in children with PB who still have prolonged cough and atelectasis after a regular course of antibiotic therapy. Flexible bronchoscopy and etiological examination should be performed in a timely manner to determine the diagnosis, clear the airway obstruction, and target etiological treatment.
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Affiliation(s)
- Yan-Ru Liu
- Department of Pediatric Respiratory Medicine, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan Province, China
| | - Tao Ai
- Department of Pediatric Respiratory Medicine, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan Province, China
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Zhang FZ, Qin L, Yuan JX, Tang LF. Plastic bronchitis due to adenoviral infection: a case report. BMC Pediatr 2020; 20:61. [PMID: 32039717 PMCID: PMC7008568 DOI: 10.1186/s12887-020-1954-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 02/03/2020] [Indexed: 12/12/2022] Open
Abstract
Background Plastic bronchitis (PB) frequently occurs as a serious postoperative complication of the Fontan procedure. The definitive causes of PB are unknown. Case presentation Herein, we report a pediatric case of PB secondary to adenoviral infection. A 4-year-old girl was admitted to the general pediatric ward for cough since 2 weeks and fever since 11 days. Consolidated lesions were noted in the right upper and both lower lung lobes. Extracorporeal membrane oxygenation was performed because the patient’s respiratory failure remained unalleviated despite the use of a ventilator. Bronchial dendritic casts were extracted using flexible bronchoscopy, and the patient’s breathing improved. Pathological examination of the dendritic cast confirmed the diagnosis of type I PB. The exfoliated cells of sputum and cells from bronchoalveolar lavage fluid were positive for adenoviral antigen. Human adenovirus 7 was detected by next-generation sequencing of the bronchoalveolar lavage fluid. The patient recovered and was discharged 39 days after admission without recurrence of cough or wheezing. Conclusions PB due to human adenovirus 7 infection should be considered in children with persistent respiratory failure. Flexible bronchoscopy should be performed early to confirm diagnosis and to remove any airway obstruction.
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Affiliation(s)
- Fei Zhou Zhang
- Zhejiang University School of Medicine of Children's Hospital, 3333 Binsheng Road, Hangzhou, 310051, China
| | - Lu Qin
- Zhejiang University School of Medicine of Children's Hospital, 3333 Binsheng Road, Hangzhou, 310051, China
| | - Jie Xin Yuan
- Zhejiang University School of Medicine of Children's Hospital, 3333 Binsheng Road, Hangzhou, 310051, China
| | - Lan Fang Tang
- Zhejiang University School of Medicine of Children's Hospital, 3333 Binsheng Road, Hangzhou, 310051, China.
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9
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Chasing the Lymph: New Clues for the Management of Idiopathic Plastic Bronchitis. Ann Am Thorac Soc 2018; 13:1671-1673. [PMID: 27726438 DOI: 10.1513/annalsats.201607-570ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Coen M, Daniel L, Serratrice J. An adult case of plastic bronchitis: a rare and multifactorial disease. J Thorac Dis 2018; 10:E16-E19. [PMID: 29600096 DOI: 10.21037/jtd.2017.12.02] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Plastic bronchitis is a rare and potentially fatal disease. Mainly a disease of the pediatric age, a few adult cases occurring after cardiac surgery have been described. We describe a case of a 41-year-old man suffering from several episodes of acute dyspnea and cough with expectoration of mucous plugs in the context of chronic allergic airway inflammation. We believe that the occurrence of plastic bronchitis in adulthood should not be overlooked particularly in patients with chronic inflammatory lung disease.
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Affiliation(s)
- Matteo Coen
- Department of Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Laurent Daniel
- Department of Pathology, La Timone University Hospital, Marseille, France
| | - Jacques Serratrice
- Department of Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
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11
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Successful Thoracic Duct Ligation for Plastic Bronchitis in an Adult. Ann Thorac Surg 2017; 103:e539-e540. [PMID: 28528062 DOI: 10.1016/j.athoracsur.2016.12.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/21/2016] [Accepted: 12/26/2016] [Indexed: 11/21/2022]
Abstract
Plastic bronchitis is a rare and potentially life-threatening disease characterized by the development of obstructive fibrinous tracheobronchial casts and hypoxic respiratory failure. With its poorly understood cause and rare occurrence in the adult population, few treatment strategies have been described in adults with this condition. In this report, we present a case of successful treatment of an adult with plastic bronchitis, using thoracic duct ligation and resulting in full resolution of airway cast development.
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12
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Robinson M, Smiley M, Kotha K, Udoji T. Plastic Bronchitis Treated With Topical Tissue-Type Plasminogen Activator and Cryotherapy. Clin Pediatr (Phila) 2016; 55:1171-5. [PMID: 26507250 DOI: 10.1177/0009922815614358] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - Kavitha Kotha
- Nationwide Children's Hospital, Columbus, OH, USA Ohio State University, Columbus, OH, USA
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Sheikh AY, Ahmadi-Kashani M, Mohindra V, Friedenberg A, Pramanik SB, Ogden WD. A Rare Case of Plastic Bronchitis in an Adult Patient After Cardiopulmonary Bypass. Ann Thorac Surg 2016; 101:1176-8. [PMID: 26897202 DOI: 10.1016/j.athoracsur.2015.05.124] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 05/19/2015] [Accepted: 05/26/2015] [Indexed: 11/30/2022]
Abstract
Plastic bronchitis is a rare life-threatening complication observed after cardiopulmonary bypass (CPB). We describe a case of a 54-year-old man in whom a fulminant case of plastic bronchitis developed after coronary artery bypass grafting (CABG) and mitral valve repair. A brief review of the literature is also presented.
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Affiliation(s)
- Ahmad Y Sheikh
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California.
| | - Mastaneh Ahmadi-Kashani
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California
| | - Vibha Mohindra
- Division of Pulmonary and Critical Care, Department of Medicine, Santa Clara Valley Medical Center, San Jose, California
| | - Allison Friedenberg
- Division of Pulmonary and Critical Care, Department of Medicine, Santa Clara Valley Medical Center, San Jose, California
| | - Sharmila B Pramanik
- Department of Pathology, Santa Clara Valley Medical Center, San Jose, California
| | - William D Ogden
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California
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14
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Barnes L, Reed RM, Parekh KR, Bhama JK, Pena T, Rajagopal S, Schmidt GA, Klesney-Tait JA, Eberlein M. MECHANICAL VENTILATION FOR THE LUNG TRANSPLANT RECIPIENT. CURRENT PULMONOLOGY REPORTS 2015; 4:88-96. [PMID: 26495241 DOI: 10.1007/s13665-015-0114-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Mechanical ventilation (MV) is an important aspect in the intraoperative and early postoperative management of lung transplant (LTx)-recipients. There are no randomized-controlled trials of LTx-recipient MV strategies; however there are LTx center experiences and international survey studies reported. The main early complication of LTx is primary graft dysfunction (PGD), which is similar to the adult respiratory distress syndrome (ARDS). We aim to summarize information pertinent to LTx-MV, as well as PGD, ARDS, and intraoperative MV and to synthesize these available data into recommendations. Based on the available evidence, we recommend lung-protective MV with low-tidal-volumes (≤6 mL/kg predicted body weight [PBW]) and positive end-expiratory pressure for the LTx-recipient. In our opinion, the MV strategy should be based on donor characteristics (donor PBW as a parameter of actual allograft size), rather than based on recipient characteristics; however this donor-characteristics-based protective MV is based on indirect evidence and requires validation in prospective clinical studies.
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Affiliation(s)
- Lindsey Barnes
- Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics
| | - Robert M Reed
- Division of Pulmonary and Critical Care Medicine, University of Maryland
| | - Kalpaj R Parekh
- Department of Thoracic and Cardiovascular Surgery, University of Iowa Hospitals and Clinics
| | - Jay K Bhama
- Department of Thoracic and Cardiovascular Surgery, University of Iowa Hospitals and Clinics
| | - Tahuanty Pena
- Division of Allergy, Pulmonary and Critical Care Medicine, University of Pennsylvania
| | | | - Gregory A Schmidt
- Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics
| | - Julia A Klesney-Tait
- Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics
| | - Michael Eberlein
- Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics
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