Liu Fen, Zhao Linlin, Gao Yanpeng, Wang Xiaoyan, Zhang Han
Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Pediatrics, The First Hospital of Yulin, Yulin, China.
Front Pediatr. 2025 Aug 26;13:1632989. doi: 10.3389/fped.2025.1632989. eCollection 2025.
While plastic bronchitis (PB) is most commonly associated with viral pathogens and (MP) infections, fungal etiologies are exceptionally uncommon in children. We described a case of a 10-year-old girl with -induced PB. She had a 10-month history of intermittent coughing as the predominant symptom, without acute progressive dyspnea. Her medical history included cystic fibrosis (CF) complicated by allergic bronchopulmonary aspergillosis (ABPA). The bronchoscopy revealed a large amount of thick, gelatinous mucus plugs in the right lower lobe bronchus. After two fiberoptic bronchoscopy procedures, the plugs were removed and turned out to be large gelatinous bronchial casts. Fungal culture of the bronchoalveolar lavage fluid (BALF) was positive for , and pathological examination of the bronchial casts revealed hyphae. This case demonstrates a chronic onset process, with significantly delayed cast formation compared to PB cases caused by other pathogens. Notably, -associated casts exhibited marked differences in CT imaging characteristics, gross morphological features and histopathological profiles when compared to MP-associated casts. The current case suggests that may be an additional cause of PB. Clinicians should include this pathogen in the differential diagnosis of patients presenting with prolonged symptom duration, CT evidence of high-attenuation mucus plugs and casts exhibiting gelatinous texture.
虽然塑料支气管炎（PB）最常与病毒病原体和支原体（MP）感染相关，但真菌病因在儿童中极为罕见。我们描述了一例10岁女孩因[具体真菌名称未给出]诱发PB的病例。她有10个月的间歇性咳嗽为主的症状病史，无急性进行性呼吸困难。她的病史包括囊性纤维化（CF）合并变应性支气管肺曲霉病（ABPA）。支气管镜检查显示右下叶支气管有大量浓稠的凝胶状黏液栓。经过两次纤维支气管镜检查，黏液栓被取出，结果是大的凝胶状支气管铸型。支气管肺泡灌洗液（BALF）的真菌培养[具体真菌名称未给出]呈阳性，支气管铸型的病理检查显示有[具体真菌名称未给出]菌丝。该病例显示出慢性起病过程，与其他病原体引起的PB病例相比，铸型形成明显延迟。值得注意的是，与[具体真菌名称未给出]相关的铸型在CT成像特征、大体形态特征和组织病理学特征方面与MP相关的铸型有明显差异。目前的病例表明[具体真菌名称未给出]可能是PB的另一个病因。临床医生在对症状持续时间长、CT有高衰减黏液栓证据且铸型呈凝胶状质地的患者进行鉴别诊断时应考虑到这种病原体。
