Plastic bronchitis associated with Botrytis cinerea infection in a child: A case report

BACKGROUND: Plastic bronchitis (PB) frequently occurs in children after the surgical repair of congenital cardiac defects or in the presence of inflammatory or allergic diseases of the lung. Accurate epidemiological data of this condition are still lacking. CASE SUMMARY: A 5-year-old boy, with a clear medical history, presented to our hospital with persistent cough and pneumonia with segmental atelectasis on chest computerized tomography. He showed no significant improvement after 1 wk of amoxicillin-clavulanate potassium treatment. Bronchial casts were extracted using flexible bronchoscopy. Pathological examination of the dendritic cast confirmed the diagnosis of type I PB. Botrytis cinerea was detected by next-generation sequencing of the bronchoalveolar lavage fluid. After the removal of the airway obstruction and fluconazole treatment, the patient recovered and was discharged 14 d after admission without the recurrence of cough. CONCLUSION: Botrytis cinerea pneumonia should be considered in children with PB who still have prolonged cough and atelectasis after a regular course of antibiotic therapy. Flexible bronchoscopy and etiological examination should be performed in a timely manner to determine the diagnosis, clear the airway obstruction, and target etiological treatment.