Etiology and Clinical Characteristics of Community-Acquired Pneumonia with Airway Malacia in Children

J Trop Pediatr. 2018 Aug 1;64(4):317-325. doi: 10.1093/tropej/fmx071.

Abstract

Objective: The objective of this article is to study the etiology of community-acquired pneumonia in children with airway malacia.

Methods: We retrospectively reviewed the medical records of 428 pneumonia patients. All patients underwent bronchoscopy, and bronchoalveolar lavage samples were processed for microbiological assessment.

Results: In a total of 428 cases reviewed, 60 were found to have airway malacia. Pathogens were identified in 44 of the 60 specimens (73.3%), with 32 being single-pathogen infections. The most common pathogen was respiratory syncytial virus (RSV; 20%). Mixed-pathogen infections were observed in 12 patients. Airway malacia patients were younger than those without malacia (10.5 vs. 50 months, respectively; p < 0.001). Compared with those without airway malacia, wheezing, cyanosis and admission to the pediatric intensive care unit were more common in children with airway malacia and their hospital stay was longer.

Conclusion: RSV was the most common pathogen in those with airway malacia. Airway malacia was found to aggravate infectious pneumonia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Airway Obstruction / etiology*
  • Bocavirus / genetics
  • Bocavirus / isolation & purification
  • Bronchoscopy*
  • Child
  • Child, Preschool
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / microbiology*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Infant
  • Length of Stay
  • Male
  • Metapneumovirus / genetics
  • Metapneumovirus / isolation & purification
  • Outcome Assessment, Health Care
  • Pneumonia / diagnosis*
  • Pneumonia / microbiology
  • Respiratory Sounds / etiology*
  • Respiratory Syncytial Viruses / genetics
  • Respiratory Syncytial Viruses / isolation & purification*
  • Severity of Illness Index
  • Tracheobronchomalacia / complications*
  • Tracheobronchomalacia / diagnosis