Related Experiment Videos
Post-infectious bronchiolitis obliterans: clinical, radiological and pulmonary function sequelae
A B Chang1, J P Masel, B Masters
1Mater Misericordiae Children's Hospital, South Brisbane, Queensland 4101, Australia.
Insights
Children with post-infectious bronchiolitis obliterans (BO) often experience long-term asthma and bronchiectasis. Fixed airway obstruction is a common pulmonary function sequela, with distinct chest radiograph patterns observed over time.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Radiology
Background:
- Limited data exist on long-term sequelae in children with post-infectious bronchiolitis obliterans (BO).
- Understanding clinical, imaging, and pulmonary function outcomes is crucial for managing this condition.
Purpose of the Study:
- To analyze diagnostic methods for post-infectious BO in children.
- To evaluate long-term clinical, imaging, and pulmonary function sequelae.
Main Methods:
- Retrospective analysis of imaging (CXR, CT, nuclear scans) and clinical histories from 19 children.
- Long-term clinical follow-up and pulmonary function testing.
Main Results:
- High incidence of persistent asthma and bronchiectasis observed.
- Fixed airway obstruction was the most frequent pulmonary function sequela.
- Five distinct patterns of chest radiograph sequelae were identified and illustrated.
Conclusions:
- Long-term follow-up is essential for detecting bronchiectasis and obstructive airway disease in children with post-infectious BO.
- Chest radiograph findings can include patterns beyond those previously described.
- Bronchography and lung biopsy are typically unnecessary for diagnosing post-infectious BO.
Abstract:
Background. There are few data on clinical, chest radiograph (CXR) or pulmonary function sequelae in children with post-infectious bronchiolitis obliterans (BO) (pulmonary crepitations, abnormalities on CXR, CT, nuclear medicine scans, or bronchography, with a history of past pulmonary infection and in the absence of other underlying pathology). Objective. To analyse the methodology of diagnosis, long-term clinical imaging and pulmonary function sequelae of post-infectious BO in children. Materials and methods. Imaging (CXRs, CT and nuclear lung scans) and clinical histories of 19 children were analysed. Results. Clinical follow-up (mean 6.8 years), revealed a high incidence of continuing problems (asthma and bronchiectasis). Fixed airway obstruction was the most common pulmonary function sequela. The sequelae on follow-up (mean 5.8 years) CXR were classified into five patterns which are illustrated: unilateral hyperlucency of an enlarged lung/part of lung; complete collapse of the affected lobe; unilateral hyperlucency of a small or normal-sized lung; bilateral hyperlucent lungs and a mixed pattern of persistent collapse, hyperlucency and peribronchial thickening. Conclusion. Long-term observations in children with post-infectious BO should be undertaken to detect bronchiectasis and obstructive airway disease. Sequelae evident on CXR, other than those previously described, can be found. Bronchography and/or lung biopsy are not usually required for the diagnosis of post-infectious BO.