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Plastic Bronchitis in Three Children Associated With 2009 Influenza A(H1N1) Virus Infection

Jikui Deng, MD; Yuejie Zheng, MD; Chengrong Li, MD; Zhuoya Ma, MD; Heping Wang, MD; Bruce K. Rubin, MD, FCCP
Author and Funding Information

From the Division of Respiratory Disease (Drs Deng, Zheng, Li, Ma, and Wang), Shenzhen Children’s Hospital, Chongqing Medical University, Shenzhen, China; and the Department of Pediatrics (Dr Rubin), Virginia Commonwealth University, Richmond, VA.

Correspondence to: Bruce K. Rubin, MD, FCCP, Dept of Pediatrics, Virginia Commonwealth University School of Medicine, 1001 E Marshall St, 2nd Floor, Richmond, VA 23298; e-mail: brubin@vcu.edu


Funding/Support: This work was supported by research grants from the Shenzhen Bureau of Health (2005C03) and State Key Laboratory of Respiratory Diseases, Guangzhou Medical College.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(6):1486-1488. doi:10.1378/chest.10-0548
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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.

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