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Chronic pulmonary complications of early influenza virus infection in children
Abstract:
In 3 male patients, chronic pulmonary sequelae followed influenza virus infection at 5, 24, and 42 months of age. Varying degrees of interstitial fibrosis, bronchial and bronchiolar erosions and metaplasia, obliterative bronchiolitis, and interstitial chronic inflammatory infiltrates were found on lung biopsy. Influenza A/Hong Kong/68 (H3N2) virus was isolated from the lung tissue of one patient 8 weeks after the onset of illness. This is the longest persistence of infectious virus in lung tissue yet reported. Persistent radiographic abnormalities included peribronchial thickening, interstitial densities, bronchiectasis, obliterative bronchiolitis, and segmental atelectasis. Pulmonary function tests showed an obstructive restrictive pattern, with mild improvement after bronchodilation and with deterioration after exercise. These observations suggest that influenza virus infection may be more serious in infants and young children than has been previously recognized and may contribute to the pathogenesis of unexplained interstitial pneumonitis, pulmonary fibrosis, obliterative bronchiolitis, and bronchiectasis.
Insights
Infant influenza virus infection can cause severe, long-term lung damage, including fibrosis and bronchiolitis. Infectious virus persisted for 8 weeks, highlighting the serious potential of pediatric respiratory infections.
Area of Science:
- Pediatric Pulmonology
- Virology
- Pathology
Background:
- Influenza virus infections are common in infants and young children.
- The long-term pulmonary sequelae following infant influenza are not well understood.
Observation:
- Three male infants experienced chronic pulmonary issues after influenza virus infection.
- Lung biopsies revealed interstitial fibrosis, bronchial/bronchiolar damage, and inflammation.
- Infectious Influenza A/Hong Kong/68 (H3N2) virus was isolated 8 weeks post-infection, indicating prolonged viral persistence.
Findings:
- Radiographic abnormalities included peribronchial thickening, interstitial densities, bronchiectasis, and atelectasis.
- Pulmonary function tests demonstrated obstructive and restrictive patterns.
- Some improvement was noted with bronchodilation, but exercise exacerbated symptoms.
Implications:
- Influenza virus infection may have more severe consequences in infants than previously recognized.
- This can contribute to the pathogenesis of unexplained interstitial pneumonitis, pulmonary fibrosis, and bronchiectasis.
- Highlights the need for further research into long-term pediatric respiratory health post-infection.