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Sci Rep . Clinical presentations and diagnostic approaches of pediatric necrotizing tracheobronchitis with influenza A virus and Staphylococcus aure

tetano

Editor, Senior Moderator
Sci Rep


. 2024 Sep 6;14(1):20880.
doi: 10.1038/s41598-024-71867-5. Clinical presentations and diagnostic approaches of pediatric necrotizing tracheobronchitis with influenza A virus and Staphylococcus aureus co-infections

Chanchan Hu[SUP] 1 [/SUP], Nan Zhang[SUP] 1 [/SUP], Dan Xu[SUP] 1 [/SUP], Zhenjie Chen[SUP] 1 [/SUP], Jia Yu[SUP] 1 [/SUP], Zihao Yang[SUP] 2 [/SUP], Chenmei Zhang[SUP] 1 [/SUP]



Affiliations
Abstract

In March 2023, our pediatric intensive care unit (PICU) retrospectively examined six cases of pediatric necrotizing tracheobronchitis (NTB), focusing on co-infections with influenza A virus (IAV) and Staphylococcus aureus (S. aureus). This study aimed to elucidate NTB's clinical characteristics, diagnostics, and therapeutic approaches. Diagnostics included symptom assessment, microbiological testing that confirmed all patients were positive for IAV H1N1 with a predominant S. aureus co-infection, and bronchoscopy. The patients predominantly exhibited fever, cough, and dyspnea. Laboratory analysis revealed decreased lymphocyte counts and elevated infection markers like C-reactive protein and procalcitonin. Chest computed tomography (CT) scans detected tracheobronchial obstructions in half of the cases, while bronchoscopy showed severe mucosal congestion, edema, necrosis, and purulent-hemorrhagic exudates. Treatments encompassed comprehensive strategies like oxygen therapy, intubation, bronchoscopic interventions, thoracentesis, oseltamivir, and a regimen of antibiotics. Our findings suggested potential correlations between clinical markers, notably lymphocyte count and procalcitonin, and clinical interventions such as the number of rescues and intensive care unit (ICU) duration. This research highlights the importance of early detection and the role of bronchoscopy and specific markers in assessing NTB, advocating for continued research in larger cohorts to better understand its clinical trajectory and refine treatment approaches for this challenging pediatric disease.

Keywords: Staphylococcus aureus; Bronchoscopy; Influenza A virus; Necrotizing tracheobronchitis; Pediatric.

 
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