1.Introduction
Plastic bronchitis (PB) is an uncommon pulmonary disease characterized by formation of bronchial casts (BCs) in airways, which can partially or completely obstruct the tracheobronchial tree1. Previously, PB was usually reported in children with surgically palliated congenital heart disease, especially those after the Fontan procedure2. With the wide application of fiberoptic bronchoscopy (FOB) in bronchopulmonary disease, accumulating evidence indicated that PB can be triggered by common pathogens of respiratory tract infection including influenza virus (A and B), adenovirus (ADV) and Mycoplasma pneumoniae (MP) 3-7, suggesting that PB may not be a rare disease.
The clinical manifestations of PB include repeated fever, shortness of breath and can rapidly progress to acute dyspnea and even life-threatening respiratory failure 8,9. As PB is a serious disease which can endanger lives without timely management, we explored and analyzed the clinical characteristics, laboratory examinations, imaging features and management of 269 children with PB to help clinians recognize it in time and apply effective treatment promptly.To the best of our knowledge, this study is the largest research of PB in children and is the first study to identify risk factors of multiple FOB therapy in PB patients.