Journal of Clinical Pediatrics ›› 2019, Vol. 37 ›› Issue (6): 423-.doi: 10.3969/j.issn.1000-3606.2019.06.006

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Bronchitis obliterans due to Mycoplasma Pneumoniae pneumonia in children: a case report and literature review

YI Qian1,2, WU Yi1,2, LI Yuanyuan1,2, TIAN Xiaoyin1, ZHANG Guangli1, XIE Xiaohong1, LUO Zhengxiu1   

  1. 1.Department of Respiratory, Children's Hospital of Chongqing Medical University; 2.Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base for Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
  • Online:2019-06-15 Published:2019-06-10

Abstract: Objective To explore the clinical characteristics of bronchitis obliterans due to Mycoplasma pneumoniae pneumonia (MPP). Methods The clinical data of bronchitis obliterans due to MPP in a child was retrospectively analyzed, and the related literature was reviewed. The clinical, imaging, and bronchoscopic features of bronchitis obliterans secondary to MPP were summarized. Results A 4-year-old boy presented with shortness of breath and activity intolerance after 1 month of severe MPP. Physical examination revealed left thoracic collapse and low breathing sound in left lung. Pulmonary imaging showed a shift of the mediastinal heart shadow to the left, atelectasis and bronchiectasis in left lower lobe and mosaic perfusion in right lung. Bronchoscopy showed sub-branch occlusion of left upper tongue lobe segment and left lower anterior outer basal segment. After bronchoscopic balloon dilatation twice, bronchoalveolar lavage and budesonide atomization inhalation, the chest CT showed partial pulmonary reexpansion six months later. From the search, nineteen papers were retrieved including a total of 72 cases, 49 of which had a history of MPP. The children gradually presented shortness of breath, wheezing, activity intolerance and other manifestations within 1-2 months after MPP. Bronchial breath sound can be heard in the affected side. Imaging was characterized by persistent pulmonary consolidation or atelectasis. After sequential treatment with azithromycin combined with glucocorticoids and bronchoscopy, 8 of the 17 patients who received follow-up were improved. Conclusion Secondary to MPP, when a patient manifested shortness of breath, wheezing and impaired activity tolerance and imaging examination suggested unilateral atelectasis, clinicians should be alerted to the occurrence of bronchitis obliterans. Early diagnosis and treatment by the use of bronchoscopy may play a positive role in improving prognosis.

Key words: Mycoplasma pneumoniae pneumonia; bronchitis obliterans; bronchoscopy; child