What question did this study set out to answer?

This research aims to identify predictors of bronchitis obliterans in pediatric patients with mycoplasma pneumoniae pneumonia complicated by bronchial casts.

March 14, 2026Open Access

Predictors for pediatric bronchitis obliterans in Mycoplasma pneumoniae pneumonia with bronchial casts

Key Points

This research aims to identify predictors of bronchitis obliterans in pediatric patients with mycoplasma pneumoniae pneumonia complicated by bronchial casts.
Retrospective analysis of 236 hospitalized children with mycoplasma pneumoniae pneumonia and bronchial casts.
Comparison of clinical features, laboratory data, radiological findings, and bronchoscopic features between PBO and non-PBO groups.
Used multivariable logistic regression to identify significant predictors of bronchitis obliterans.
Children with bronchitis obliterans had higher pleural effusion incidence and severe radiological abnormalities.
PBO group exhibited higher C-reactive protein, white blood cell count, and erythrocyte sedimentation rate than the non-PBO group.
Significant predictors included ESR > 57.5 mm/h, pulmonary consolidation > 2/3 of a lobe, and delayed bronchoscopy, with specific odds ratios to each.

Abstract

Bronchitis obliterans is a major complication of Mycoplasma pneumoniae pneumonia (MPP) with bronchial casts. This retrospective study aimed to identify predictors of pediatric bronchitis obliterans (PBO) in patients with mycoplasma pneumoniae pneumonia (MPP) complicated by bronchial casts. We screened 236 hospitalized children with MPP and bronchial casts on bronchoscopy between June 2018 and June 2023, of whom 197 were included in the analysis, including 49 with PBO and 148 without PBO. The clinical features, laboratory data, radiological findings, and bronchoscopic features of the children in the PBO and non-PBO groups were compared. Children in the PBO group had a significantly higher incidence of pleural effusion, more severe radiological abnormalities, and higher C-reactive protein level, white blood cell count, erythrocyte sedimentation rate (ESR), and immunoglobulin M level than those in non-PBO group. Additionally, children in the PBO group were more likely to have delayed bronchoscopy (> 13.5 days). Multivariable logistic regression analysis revealed that ESR > 57.5 mm/h (OR: 3.833, P = 0.001), pulmonary consolidation > 2/3 of a lobe (OR: 2.453, P = 0.036) and delayed bronchoscopy (OR 5.827, P < 0.001) were significant predictors of PBO in patients with MPP complicated by bronchial casts.These three indicators combined had a sensitivity of 0.571, specificity of 0.885, and area under the curve of 0.766 for predicting PBO.

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