Plastic bronchitis in three children associated with 2009 influenza A(H1N1) virus infection.
Plastic bronchitis is an uncommon disorder generally associated with congenital heart disease or sickle cell acute chest syndrome. During the winter outbreak of 2009 influenza A(H1N1) [influenza A(H1N1)] virus infection, we cared for three children who developed plastic bronchitis without the typical underlying conditions. The diagnosis of plastic bronchitis was made using flexible bronchoscopy and was confirmed by histopathology. These children had influenza-like illness, and the assay for influenza A(H1N1) virus was positive in their nasopharyngeal swab and BAL fluid. The chest imaging showed consolidation or atelectasis. After bronchoscopic extraction of casts and antiviral treatment, all of the patients recovered, and there has been no recurrence of the plastic bronchitis. Infection with influenza A(H1N1) is known to cause inflammation and decreased mucociliary clearance, and this may place some patients, especially children, at risk for airway obstruction.
Dept of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA. brubin@vcu.edu
Jikui
J
Deng
Yuejie
Y
Zheng
Chengrong
C
Li
Zhuoya
Z
Ma
Heping
H
Wang
Bruce K
BK
Rubin
D000998:Antiviral Agents / Q000627:therapeutic use; D001991:Bronchitis / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D001992:Bronchoalveolar Lavage Fluid / Q000821:virology; D001999:Bronchoscopy / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D007362:Intensive Care Units; D008297:Male; D001261:Pulmonary Atelectasis / Q000175:diagnosis / Q000473:pathology / Q000821:virology; D035583:Rare Diseases; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000821:virology; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome
D000998:Antiviral Agents