Analysis of risk factors of mycoplasma pneumonia associated plastic bronchitis in children

Objective During the last few years, the number of cases of severe pneumonia that correspond with mycoplasma pneumoniae has risen. It increases the risk of more complications in children and likelihood of being admitted to the intensive care unit.It is especially crucial to screen for plasticl bronchitis because which requires bronchoscopy and alveolar lavage to promote the recovery of pneumonia, and some may require multiple bronchoscopies to remove the lesions to promote the recovery. They are also at risk of occlusive bronchitis with plasticl bronchitis, which require long-term treatment and respiratory management. In particular, early diagnosis and therapy are crucial. Methods A total of 90 cases of children with mycoplasma pneumonia in the paediatrics department of Dongguan Maternal and Child Health Hospital from September 2022 to September 2024 were collected, including 35 cases of mycoplasma pneumonia combined with plastic bronchiolitis (PB), 25 cases of non-plastic severe mycoplasma pneumonia (non-PB), and 30 cases of usual mycoplasma pneumonia(UP).Age, fever time, neutrophil and lymphocyte ratio(NLR) in blood routine, ferritin(FeO), lactate dehydrogenase(LDH), and D-dimer were counted. Results (1) ANOVA revealed that when mycoplasma infection, NLR, Age, CRP, FeO, and D-dimer were significantly higher in the PB group than UP group(P < 0.05). However, all of the above factors, with the exception of NLR, did not differ s-ubstantially between the PB group and the non-PB group (P > 0.05). (2)Logistic analysis indicated that there was a positive correlation between NLR and D-dimer with PB group,NLR(odds ratio[OR]2.14,95%confidence interval[CI]:1.08–4.2,P = 0.029).(3)The area under the receiver operating characteristic (ROC)curve of NLR was 0.73,95%CI:0.66–0.86, P = 0.002 ,cut-off value was 3.07,which was an independent risk factor for the development of plastic bronchitis. Conclusion (1) The ratio of neutrophils to lymphocytes is a distinct risk indicator for the onset of plastic bronchiolitis, and bronchoscopy is recommended when there are solid lesions in the lungs and the NLR ≥ 3.07.