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Post-infectious bronchiolitis obliterans in children: a review of 42 cases
Ya-Nan Li, Li Liu, Hong-Mei Qiao
1Department of Pediatrics, The First Hospital of Jilin University, Changchun 130021, PR China. hflyn2011@sina.com.
Insights
Post-infectious bronchiolitis obliterans (PIBO) in children is often caused by adenovirus or Mycoplasma pneumoniae. Combination therapy with steroids and azithromycin shows benefit for PIBO treatment.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Radiology
Background:
- Post-infectious bronchiolitis obliterans (PIBO) is a severe lung disease in children.
- Identifying clinical and radiological features is crucial for diagnosis and management.
Purpose of the Study:
- To describe the clinical characteristics, radiological findings, and outcomes of children with PIBO.
- To evaluate the effectiveness of different treatments for PIBO.
Main Methods:
- Prospective study of 42 children diagnosed with PIBO.
- Collected data on clinical presentation, high-resolution computed tomography (HRCT) findings, and pulmonary function tests.
Main Results:
- Adenovirus and Mycoplasma pneumoniae were the most common causes of PIBO.
- All patients exhibited wheezing and tachypnea; many required intensive care or oxygen therapy.
- HRCT confirmed PIBO diagnosis; pulmonary function tests aided in assessing treatment response.
Conclusions:
- Severe adenovirus and Mycoplasma pneumoniae infections increase PIBO risk.
- HRCT and pulmonary function tests are valuable diagnostic tools for PIBO.
- Combined steroids and azithromycin treatment demonstrated therapeutic benefits for PIBO.
Background:
This study aimed to describe the clinical characteristics, radiological features and outcomes of 42 children with post-infectious bronchiolitis obliterans (PIBO).
Methods:
Forty-two children diagnosed with PIBO were prospectively studied at the First Hospital of Jilin University in northern China between January, 2008 and January, 2013. Their clinical characteristics, lung high resolution computed tomography (HRCT) findings and pulmonary function tests were reported.
Results:
In children with PIBO, adenovirus was the most common etiologic agent (21/42), followed by Mycoplasma pneumoniae (M. pneumoniae). All of the patients presented with repeated wheezing and tachypnea. In addition, 22 patients required intensive management, while six patients required home oxygen therapy. HRCT findings were consistent with the PIBO diagnosis in all of the patients. Pulmonary function testing was useful in evaluating therapeutic responses. Systemic steroids combined with azithromycin were effective for PIBO treatment.
Conclusions:
Severe adenovirus bronchiolitis and M. pneumoniae infections have a higher risk of development for PIBO. HRCT and pulmonary function testing are useful in the diagnosis of PIBO. The degree of airway obstruction did not differ significantly between adenovirus and M. pneumoniae. A combination of steroids and azithromycin offers some benefit in treating these patients.
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