J Korean Med Sci.  2012 Sep;27(9):1114-1119. 10.3346/jkms.2012.27.9.1114.

Recurrent Plastic Bronchitis in a Child with 2009 Influenza A (H1N1) and Influenza B Virus Infection

Affiliations
  • 1Department of Family Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea.
  • 2Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea. youngcx@hanmail.net
  • 3Department of Pathology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea.
  • 4Department of Pediatrics, Chosun University College of Medicine, Gwangju, Korea.

Abstract

Plastic bronchitis is an uncommon disorder characterized by the formation of bronchial casts. It is associated with congenital heart disease or pulmonary disease. In children with underlying conditions such as allergy or asthma, influenza can cause severe plastic bronchitis resulting in respiratory failure. A review of the literature showed nine cases of plastic bronchitis with H1N1 including this case. We report a case of a child with recurrent plastic bronchitis with eosinophilic cast associated with influenza B infection, who had recovered from plastic bronchitis associated with an influenza A (H1N1) virus infection 5 months previously. To the best of our knowledge, this is the first case of recurrent plastic bronchitis related to influenza viral infection. If patients with influenza virus infection manifest acute respiratory distress with total lung atelectasis, clinicians should consider plastic bronchitis and early bronchoscopy should be intervened. In addition, management for underlying disease may prevent from recurrence of plastic bronchitis.

Keyword

H1N1 Subtype Influenza A Virus; Influenza B virus; Bronchitis; Bronchial Hyperreactivity

MeSH Terms

Administration, Inhalation
Adrenal Cortex Hormones/therapeutic use
Antiviral Agents/therapeutic use
Bronchitis/complications/*diagnosis/drug therapy
Bronchoscopy
Child
DNA, Viral/analysis
Dyspnea/etiology
Humans
Hypersensitivity/pathology
Influenza A Virus, H1N1 Subtype/*genetics/isolation & purification
Influenza B virus/genetics/isolation & purification
Influenza, Human/complications/*diagnosis/drug therapy
Male
Oseltamivir/therapeutic use
Pulmonary Atelectasis/drug therapy/radiography
Real-Time Polymerase Chain Reaction
Tachypnea/etiology
Tomography, X-Ray Computed
Adrenal Cortex Hormones
Antiviral Agents
DNA, Viral
Oseltamivir

Figure

  • Fig. 1 Chest radiographs at the first attack with H1N1 infection in November, 2009 (A) and second attack with influenza B infection in April, 2010 (B) shows total atelectasis in the left lung and hyperaeration in the right lung.

  • Fig. 2 Chest computed tomography (CT) at the first attack (A, C) reveals left main bronchial obstruction with low attenuated materials and atelectasis of the left lung. Chest CT after bronchoscopic removal of bronchial casts (B, D) shows recovered left lung with good aeration.

  • Fig. 3 Casts extracted from the left main bronchus at the second attack showed preserved anatomy of the bronchial tree.

  • Fig. 4 The specimen composed of denudated bronchial epithelium, fibrin clot (black arrow), mucin material (white arrow), and inflammatory exudates. The inflammatory cells were eosinophils and neutrophils (H&E stain, × 200).


Cited by  1 articles

A Case of Plastic Bronchitis Associated Influenza A Pneumonia Requiring ECMO Assistance
Hong Yul An, Seung Min Baek, Youn Young Choi, You sun Kim, Eui Jun Lee, Yu Hyeon Choi, Yun Jung Choi, Dong In Suh, Jae Gun Kwak, Woong-Han Kim, June Dong Park
Pediatr Infect Vaccine. 2018;25(2):101-106.    doi: 10.14776/piv.2018.25.e4.


Reference

1. Eberlein MH, Drummond MB, Haponik EF. Plastic bronchitis: a management challenge. Am J Med Sci. 2008. 335:163–169.
2. Neuzil KM, Mellen BG, Wright PF, Mitchel EF Jr, Griffin MR. The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med. 2000. 342:225–231.
3. World Health Organization. H1N1 in post-pandemic period. Accessed on 10 August 2010. Available at: http://www.who.int/mediacentre/news/statements/2010/h1n1_vpc_20100810/en/index.html.
4. Hasegawa M, Okada T, Sakata H, Nakayama E, Fuchigami T, Inamo Y, Mugishima H, Tajima T, Iwata S, Morozumi M, et al. Pandemic (H1N1) 2009-associated pneumonia in children, Japan. Emerg Infect Dis. 2011. 17:279–282.
5. Kim HS, Kim JH, Shin SY, Kang YA, Lee HG, Kim JS, Lee JK, Cho B. Fatal cases of 2009 pandemic influenza A (H1N1) in Korea. J Korean Med Sci. 2011. 26:22–27.
6. Shin SY, Kim JH, Kim HS, Kang YA, Lee HG, Kim JS, Lee JK, Kim WK. Clinical characteristics of Korean pediatric patients critically ill with influenza A (H1N1) virus. Pediatr Pulmonol. 2010. 45:1014–1020.
7. Lee E, Seo JH, Kim HY, Na S, Kim SH, Kwon JW, Kim BJ, Hong SJ. Clinical characteristics and outcomes among pediatric patients hospitalized with pandemic influenza A/H1N1 2009 infection. Korean J Pediatr. 2011. 54:329–334.
8. Terano C, Miura M, Fukuzawa R, Saito Y, Arai H, Sasaki M, Ariyasu D, Hasegawa Y. Three children with plastic bronchitis associated with 2009 H1N1 influenza virus infection. Pediatr Infect Dis J. 2011. 30:80–82.
9. Deng J, Zheng Y, Li C, Ma Z, Wang H, Rubin BK. Plastic bronchitis in three children associated with 2009 influenza A (H1N1) virus infection. Chest. 2010. 138:1486–1488.
10. Hasegawa M, Inamo Y, Fuchigami T, Hashimoto K, Morozumi M, Ubukata K, Watanabe H, Takahashi T. Bronchial casts and pandemic (H1N1) 2009 virus infection. Emerg Infect Dis. 2010. 16:344–346.
11. Sun DJ, Yang YS, Wang BC. Plastic bronchitis associated with severe influenza A (H1N1) in children: a case report and review of the literature. Zhonghua Jie He He Hu Xi Za Zhi. 2010. 33:837–839.
12. Brogan TV, Finn LS, Pyskaty DJ Jr, Redding GJ, Ricker D, Inglis A, Gibson RL. Plastic bronchitis in children: a case series and review of the medical literature. Pediatr Pulmonol. 2002. 34:482–487.
13. Hasegawa S, Hirano R, Hashimoto K, Haneda Y, Shirabe K, Ichiyama T. Characteristics of atopic children with pandemic H1N1 influenza viral infection: pandemic H1N1 influenza reveals 'occult' asthma of childhood. Pediatr Allergy Immunol. 2011. 22:e119–e123.
14. Xepapadaki P, Papadopoulos NG, Bossios A, Manoussakis E, Manousakas T, Saxoni-Papageorgiou P. Duration of postviral airway hyperresponsiveness in children with asthma: effect of atopy. J Allergy Clin Immunol. 2005. 116:299–304.
15. Bowen A, Oudjhane K, Odagiri K, Liston SL, Cumming WA, Oh KS. Plastic bronchitis: large, branching, mucoid bronchial casts in children. AJR Am J Roentgenol. 1985. 144:371–375.
16. Ko JH, Kim JH, Kang JH, Kim JH, Eun BW, Kim KY, Hong JY, Oh SH. Characteristics of hospitalized children with 2009 pandemic influenza A(H1N1): a multicenter study in Korea. J Korean Med Sci. 2012. 27:408–415.
17. Fiore AE, Uyeki TM, Broder K, Finelli L, Euler GL, Singleton JA, Iskander JK, Wortley PM, Shay DK, Bresee JS, Cox NJ. Centers for Disease Control and Prevention (CDC). Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Recomm Rep. 2010. 59:1–62.
18. Kwon S, Kim S, Cho MH, Seo H. Neurologic complications and outcomes of pandemic (H1N1) 2009 in Korean children. J Korean Med Sci. 2012. 27:402–407.
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr