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[Follicular bronchiolitis: a pediatric case report]
A Labbé1, P Déchelotte, I Creveaux
1Service de Pédiatrie A, Hôtel-Dieu, Clermont-Ferrand.
Insights
This case report details an infant with persistent bronchiolitis and respiratory failure, unresponsive to standard treatments. Diagnosis required lung biopsy, revealing follicular bronchitis and suggesting genetic testing for delta F 508 mutations in similar cases.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Case Study
Background:
- Bronchiolitis is a common respiratory infection in infants.
- Persistent or severe cases may indicate underlying conditions.
- Standard treatments often include bronchodilators and corticosteroids.
Observation:
- A six-month-old infant presented with insidious bronchiolitis, progressing to respiratory failure and failure to thrive.
- Conventional therapies, including corticosteroids and bronchodilators, were ineffective.
- Assisted ventilation was required for three weeks due to persistent bronchial obstruction.
Findings:
- Open lung biopsy revealed characteristic lesions of bronchiolitis and follicular bronchitis.
- No other parenchymal lung disease was identified.
- The patient showed clinical and radiological improvement with antibiotics and physiotherapy.
Implications:
- Follicular bronchitis in infants warrants thorough investigation for underlying causes.
- The possibility of heterozygous delta F 508 mutation should be considered in unexplained obstructive airway disease.
- Genetic screening for delta F 508 may aid in diagnosing and managing chronic respiratory issues in infants.
Abstract:
A case of bronchiolitis of insidious evolution appearing in an unweened infant aged six months is reported. Initially an acute episode of bronchial obstruction was followed by respiratory failure with failure to thrive. The total inefficacy of conventional treatment (corticosteroids, nebulised and oral bronchodilators) led to assisted ventilation for three weeks, four months after the onset of symptoms. All investigations aimed at achieving a diagnosis were negative and this led to an open lung biopsy. This showed characteristic lesions of bronchiolitis and follicular bronchitis without other parenchymatous disease. With continuous antibiotics and physiotherapy the respiratory status improved, both clinically and radiologically. Amongst the explanations of the pathophysiology of follicular bronchitis they also discussed the existence of heterozygous delta F 508 in their observation to explain the chronicity of the problems. They stress the need to look for a mutation of delta F 508 in infants who present with unexplained obstructive bronchial pathology.