{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T14:22:43Z","timestamp":1780410163818,"version":"3.54.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>\n                    Croup is a common presentation in pediatric emergency settings, most often caused by viral infections. However, when influenza A virus co-occurs with\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    infection, it can lead to rare and lethal complications. We report a case of a 13-month-old boy who presented with fever and croup. The patient developed suffocation after 4.5 h of hoarseness and respiratory distress, with poor response to glucocorticoids therapy. Despite mechanical ventilation, respiratory failure persisted. Serial chest radiographs over a 7-h period revealed rapid progression to complete left lung atelectasis. Bronchoscopy identified complete obstruction of the left main bronchus by a purulent mucus plug, which was removed resulting in lung re-expansion. Etiological analysis confirmed co-infection with influenza A virus (H3N2) and\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    . The patient was treated with sensitive antibiotics and peramivir, and was discharged on day 9 with no recurrence of symptoms.\n                  <\/jats:p>","DOI":"10.3389\/fped.2026.1801970","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T13:40:38Z","timestamp":1780407638000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rapid progression from croup to complete lung collapse: a case report of central airway obstruction by mucopurulent cast in influenza A (H3N2) and Pseudomonas aeruginosa coinfection in a toddler"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiumin","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Pediatric, Liaocheng People's Hospital","place":["Liaocheng, Shandong Province, 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