Plastic bronchitis in pediatrics: A systematic review of etiologies, clinical presentations, treatments, and prognosis.

BACKGROUND

A growing number of literature investigates various characteristics, including etiologies, clinical presentations, imaging findings, treatment approaches, and outcomes, of plastic bronchitis (PB) in children. We aim to discuss these findings through a systematic review.

METHODS

Cochrane Central Register of Control Trials, PubMed, Medline, Google Scholar, Web of Science, Scopus, and Embase were systematically searched up to February 2025. The search strategy was described by a combination of relevant medical subheadings and keywords. Eligible English language studies were reviewed, and their quality was appraised. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.

RESULTS

A total of 37 studies, including 1527 participants, met the inclusion criteria. The most frequent etiology was infection, including both bacterial and viral infections (n = 1124). The most frequent symptoms were cough (reported in 24 out of 26 studies) and fever (reported in 20 out of 26 studies). The most prevalent imaging findings were atelectasis (reported in 18 out of 23 studies), consolidation (reported in 16 out of 23 studies), and pleural effusion (reported in 16 out of 23 studies). The combination of antibiotics, corticosteroids, and bronchoscopic cast removal was common among all the studies. The symptoms of PB were resolved in most children (82.7 %, n = 525) after treatment, and the symptoms recurred in 8.0 % (n = 51) of patients.

CONCLUSIONS

This systematic review discovered the frequency of various etiologies, clinical presentations, imaging findings, treatment approaches, and outcomes of PB in children. It also tried to develop a treatment protocol adjusted to the underlying pathophysiology.