Predictors for pediatric bronchitis obliterans in Mycoplasma pneumoniae pneumonia with bronchial casts

Bronchitis obliterans is a major complication of Mycoplasma pneumoniae pneumonia (MPP) with bronchial casts. This retrospective study aimed to identify predictors of pediatric bronchitis obliterans (PBO) in patients with mycoplasma pneumoniae pneumonia (MPP) complicated by bronchial casts. We screened 236 hospitalized children with MPP and bronchial casts on bronchoscopy between June 2018 and June 2023, of whom 197 were included in the analysis, including 49 with PBO and 148 without PBO. The clinical features, laboratory data, radiological findings, and bronchoscopic features of the children in the PBO and non-PBO groups were compared. Children in the PBO group had a significantly higher incidence of pleural effusion, more severe radiological abnormalities, and higher C-reactive protein level, white blood cell count, erythrocyte sedimentation rate (ESR), and immunoglobulin M level than those in non-PBO group. Additionally, children in the PBO group were more likely to have delayed bronchoscopy (> 13.5 days). Multivariable logistic regression analysis revealed that ESR > 57.5 mm/h (OR: 3.833, P = 0.001), pulmonary consolidation > 2/3 of a lobe (OR: 2.453, P = 0.036) and delayed bronchoscopy (OR 5.827, P < 0.001) were significant predictors of PBO in patients with MPP complicated by bronchial casts.These three indicators combined had a sensitivity of 0.571, specificity of 0.885, and area under the curve of 0.766 for predicting PBO.