Background
Plastic bronchitis is a rare but life-threatening disorder and is usually associated with congenital heart disease or pulmonary disease.
Case characteristics
A 5-year-old boy with minimal change nephrotic syndrome who developed a relapse along with cough, fever and dyspnea. Observation: Chest X-ray showed atelectasis of right upper lobe of lung, and nasal swab was positive for influenza B virus. His respiratory condition worsened, and required ventilation; bronchoscopy revealed bronchial casts. This was followed by acute kidney injury which was successfully managed with hemodialysis.
Message
Children with nephrotic syndrome on immunosuppressive agents can develop plastic bronchitis and acute kidney injury, following influenza virus infection.