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Successful treatment of diffuse panbronchiolitis in a child from Western China: A case report
Na-Na Zhao1, Hui Cao2, Shi-Si Zhang1
1Department of Respiratory Medicine, Institute of Surgery Research, The Third Affiliated Hospital, The Third Military Medical University, Chongqing 400042, P.R. China.
Insights
Early diagnosis and treatment of diffuse panbronchiolitis (DPB) in children are crucial for favorable outcomes. This case report highlights successful management of pediatric DPB with erythromycin therapy, emphasizing prompt intervention.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
Background:
- Diffuse panbronchiolitis (DPB) is a rare obstructive lung disease, infrequently diagnosed in pediatric patients.
- Recurrent respiratory symptoms like cough and dyspnea can be misdiagnosed, delaying appropriate treatment.
Purpose of the Study:
- To report a case of pediatric diffuse panbronchiolitis (DPB) in Western China.
- To emphasize the importance of early diagnosis and treatment for favorable outcomes in pediatric DPB.
Main Methods:
- A 13-year-old boy with persistent respiratory symptoms initially diagnosed with asthma was re-evaluated.
- Diagnostic criteria for DPB were met, including centrilobular opacities and a 'tree-in-bud appearance' on imaging.
- Treatment with erythromycin was initiated.
Main Results:
- The patient experienced complete disease resolution and sustained symptom alleviation after early erythromycin therapy.
- Exacerbations of chronic bronchitis were reduced.
- The case demonstrates a favorable outcome in pediatric DPB with prompt intervention.
Conclusions:
- Early diagnosis and treatment are essential for successful management of pediatric diffuse panbronchiolitis (DPB).
- Erythromycin therapy can be effective in treating pediatric DPB.
- Clinicians should consider DPB in pediatric patients with persistent, unexplained respiratory symptoms.
Abstract:
The present report describes a case of diffuse panbronchiolitis (DPB) in a child from Western China and the favorable outcome associated with early diagnosis. DPB is an uncommon presentation in pediatric patients. A 13-year-old Chinese boy was admitted to the respiratory outpatient department due to recurrent cough and progressive exertional dyspnea that had persisted for 1 year. An initial diagnosis of bronchial asthma was made, and the patient was prescribed inhaled fluticasone combined with salmeterol (50/250 µg, twice daily), and montelukast (4 mg daily). However, 2 months later no clinical improvement was observed. The disease was re-diagnosed as DPB following the identification of features such as centrilobular small nodular opacities, a 'tree-in-bud appearance' and thickening of the bronchial walls meeting the diagnostic criteria for DPB. Complete resolution of the disease and sustained alleviation of the patient's respiratory symptoms were achieved following the early institution of erythromycin therapy, and the exacerbation of chronic bronchitis was reduced. In conclusion, it is essential to consider that successful treatment for DPB lies in early diagnosis and early treatment. DPB may be treated well by use of erythromycin.
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