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Updated: Aug 29, 2026
Experimental Model to Evaluate Resolution of Pneumonia
Published on: February 17, 2023
[Respiratory sequelae of viral diseases: from diagnosis to treatment]
Alejandro Teper1, Gilberto Bueno Fischer, Marcus Herbert Jones
1Centro Respiratorio, Hospital de Niños Ricardo Gutierrez, Argentina.
Insights
Postinfectious bronchiolitis obliterans (BO) in children is typically diagnosed using imaging and clinical history, with most patients experiencing favorable outcomes and good prognosis. Treatment involves long-term corticosteroids and bronchodilators.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Respiratory Medicine
Context:
- Postinfectious bronchiolitis obliterans (PIBO) presents significant diagnostic and management challenges for pediatricians.
- PIBO is a sequela of severe lower respiratory tract infections in early childhood.
Purpose:
- To review the primary clinical issues in diagnosing, managing, and determining the prognosis of PIBO in pediatric patients.
- To synthesize current knowledge on PIBO for clinical practice.
Summary:
- Diagnosis relies on clinical history, characteristic radiological findings (pulmonary insufflation, thickened bronchovascular bundles, air trapping on CT), and reduced expiratory flows on pulmonary function tests.
- Pulmonary biopsy is generally not required; diagnosis is often established through a combination of clinical presentation and imaging.
- Treatment commonly involves prolonged use of oral and inhaled corticosteroids and bronchodilators, with antibiotics and physical therapy for exacerbations.
Impact:
- Most children with PIBO experience a favorable prognosis with gradual pulmonary function improvement and decreased oxygen dependence.
- A subset of patients may develop progressive hypoxemia and CO2 retention, potentially leading to pulmonary hypertension and cor pulmonale.
- Overall, PIBO is often mild to moderate, associated with good outcomes and low mortality rates in pediatric populations.
Objective:
The objective of the present article is to present a review of the main clinical issues faced by pediatricians while defining the diagnosis, management and prognosis of postinfectious bronchiolitis obliterans.
Sources:
Data from national and international scientific journals selected from the Lilacs and Medline databases.
Summary Of The Findings:
With the purpose of establishing the diagnosis, a radiological investigation shows high levels of pulmonary insufflation, thickened bronchovascular bundles and, less often, bronchiectasis, atelectasis and pulmonary hyperlucency. The CT exam allows the visualization of structural and functional findings, such as air trapping, bronchiectasis and mosaic pattern. Lung function tests in children and infants always reveal significant reduction of expiratory flows. Pulmonary biopsy is not mandatory in order to confirm bronchiolitis obliterans. Diagnosis can be established through the combination of history of bronchiolitis, chronic obstructive pulmonary disease and typical tomographic findings. The treatment used by most services includes oral and inhaled corticosteroids and bronchodilators for long periods. The management of exacerbated conditions often requires antibiotics and physical therapy.
Conclusions:
Most patients present a favorable outcome with slow improvement of the pulmonary function and reduced necessity for supplementary oxygen. Some patients present progressive worsening of hypoxemia and CO2 retention, which leads to pulmonary hypertension and cor pulmonale. Postinfectious bronchiolitis obliterans is mild and moderate in most patients, with consequent good prognosis and low mortality.
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