Efficacy of Fiberoptic Bronchoscopy in Noncardiac Pediatric Plastic Bronchitis: A Case Series

Abstract Plastic bronchitis (PB) is a rare disorder marked by the formation of airway-shaped bronchial casts, often seen after cardiac surgery but also in noncardiac pediatric cases. This case series presents 10 children (ages 2–12 years, equal gender distribution) with noncardiac PB managed successfully using flexible bronchoscopy. Underlying conditions included asthma, allergy, and primary ciliary dyskinesia. Viral infections such as influenza A and adenovirus were identified in three cases. Casts were removed via bronchoscopy, with one patient requiring a repeat procedure following dornase alfa instillation. Histopathology showed eosinophilic casts in most cases. Treatment included inhaled corticosteroids, with some requiring systemic steroids. All patients recovered without recurrence. This case series highlights bronchoscopy’s key role in managing pediatric PB and suggests that tailored therapies are effective. Furthermore, studies are needed to better understand its pathophysiology and guide treatment.