13例儿童博卡病毒肺炎合并塑型性支气管炎的临床与影像特点

doi:10.12372/jcp.2025.25e0551

Abstract

Abstract:

Objective To characterize the clinical and radiological features and prognosis of children with bocavirus pneumonia complicated by plastic bronchitis. Methods A retrospective analysis was conducted on the clinical data and follow-up results of 13 children diagnosed with bocavirus pneumonia complicated with plastic bronchitis in our hospital from January 2022 to January 2024. Results A total of 13 cases were included, including 7 males and 6 females, with a median age of 3.0 (1.0-5.0) years. Eight cases (61.5%) were hospitalized during summer. All patients presented with fever and cough; 7 (53.8%) had wheezing, and 3 exhibited tachypnea. The mean duration of fever was 3.92±1.26 days, with a peak temperature of 39.24±0.40 °C. Extrapolmonary complications included one case of toxic encephalopathy and one of erythema multiforme; no other organ dysfunction was observed. Laboratory findings revealed mild elevations in C-reactive protein (CRP) in 9 patients, with PCT and LDH were slightly elevated. Chest CT predominantly showed inflammatory consolidation, with atelectasis in 9 cases (69.2%) and small pleural effusions in 4 (30.8%). Bronchoalveolar lavage fluid analysis demonstrated marked eosinophilia. All patients underwent bronchoscopic removal of intraluminal casts and improved clinically, with a median hospital stay of 5.0 (4.5-6.5) days. During follow-up, one child developed recurrent wheezing and was subsequently diagnosed with asthma; the remaining patients had favorable outcomes. Conclusion Bocavirus pneumonia complicated by plastic bronchitis in children are more frequently observed during the summer months. The disease commonly presents with high fever, cough, and wheezing, with minimal elevation in inflammatory markers such as CRP, PCT, and LDH. Radiologically, consolidation and atelectasis are the predominant findings. The disease course is relatively short, and severe multi-organ involvement is uncommon. Overall, the prognosis is favorable.

Key words: plastic bronchitis, human bocavirus, medical imaging, child

CLC Number:

GAO Weiwei, ZOU Yingxue, GUO Yongsheng, GUO Run. Clinical and imaging features of children with bocavirus pneumonia associated with plastic bronchitis[J].Journal of Clinical Pediatrics, 2025, 43(11): 860-865.

Figures/Tables 3

Table 1

Clinical features of 13 pediatric patients of human bocavirus pneumonia associated with plastic bronchitis"

患儿	年龄 /岁	性别	症状体征	T_max /℃	胸部影像学	BALF的细胞学分类
例1	5	女	发热咳嗽	39.9	双肺散在炎性实变，双肺纹理粗重伴透过度不均	N23%，E21%，L3%，M51%，上皮细胞2%
例2	5	女	发热咳嗽	39.0	左肺及右肺上叶炎性实变，左侧胸膜增厚，左肺下叶支气管分支欠通畅	N4%，E31%，L8%，M56%，上皮细胞1%
例3	3	女	发热咳嗽	39.5	右肺上叶炎性实变伴肺不张，右肺上叶支气管管腔不通畅	未做
例4	1	女	发热咳嗽喘，呼吸音减低	39.6	右肺上叶大片炎性实变，伴肺不张	N13%，E17%，L4%，M65%，上皮细胞1%
例5	4	男	发热咳嗽，呼吸音减低	38.5	右肺上叶不张，右肺中叶及双肺下叶炎症，右侧胸腔少量积液	N7%，E42%，L6%，M44%，上皮细胞1%
例6	1	女	发热咳嗽喘	39.6	右肺散在炎性实变伴右肺上叶部分不张，右侧胸膜增厚，右肺上叶及中叶支气管分支不通畅	N28%，E13%，L8%，M49%，上皮细胞2%
例7	1	男	发热咳嗽喘	39.0	左肺散在炎性实变伴左肺上叶部分不张，左侧少量胸腔积液，左肺上叶支气管分支欠通畅	N61%，E15%，L5%，M18%，上皮细胞1%
例8	3	男	发热咳嗽，呼吸音减低	39.3	右肺散在炎性实变伴上叶不张，右侧胸腔积液	N81%，E0%，L3%，M15%，上皮细胞1%
例9	5	男	发热咳嗽，喘气促	39.6	双肺炎症，纵膈气肿、间质性肺气肿	N54%，E1%，L5%，M38%，上皮细胞2%
例10	5	女	发热咳嗽，气促、呼吸音减低	38.9	双肺炎症，右肺下叶肺不张，右侧少量胸腔积液	N66%，E12%，L4%，M16%，上皮细胞2%
例11	4	男	发热咳嗽喘	39.0	双肺上叶炎性实变伴左肺上叶部分不张，左肺上叶局部透过度增高，左肺上叶支气管及分支欠通畅	N81%，E5%，L2%，M9%，上皮细胞3%
例12	2	男	发热咳嗽喘	38.8	双肺散在炎性实变，右肺上叶部分不张，双肺部分支气管分支欠通畅	N21%，E1%，L21%，M55%，上皮细胞2%
例13	1	男	发热咳嗽喘，气促、呼吸音减低	39.4	右肺上叶及左肺散在炎性实变，以右肺上叶为著，右肺上叶支气管远端分支欠通畅	N61%，E5%，L6%，M27%，上皮细胞1%

Table 1

Figure 1

Figure 2

References 24

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Clinical and imaging features of children with bocavirus pneumonia associated with plastic bronchitis

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